TOM VU DENTAL CORP
NPI: 1912144114
· HUNTINGTON BEACH, CA 92647
· Preferred Provider Organization
· NPI assigned 01/10/2009
$298K
Total Medicaid Paid
Provider Details
| Authorized Official | VU, TOM (DENTIST) |
| NPI Enumeration Date | 01/10/2009 |
Related Entities
Other providers sharing the same authorized official: VU, TOM
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,571 |
$29K |
| 2019 |
1,766 |
$43K |
| 2020 |
1,263 |
$33K |
| 2021 |
1,248 |
$31K |
| 2022 |
1,493 |
$52K |
| 2023 |
1,452 |
$52K |
| 2024 |
1,482 |
$58K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
969 |
525 |
$65K |
| D0120 |
Periodic oral evaluation - established patient |
1,007 |
1,005 |
$57K |
| D0230 |
Intraoral - periapical each additional radiographic image |
3,727 |
1,972 |
$42K |
| D0274 |
Bitewings - four radiographic images |
1,440 |
1,439 |
$30K |
| D1110 |
Prophylaxis - adult |
301 |
301 |
$26K |
| D1120 |
Prophylaxis - child |
576 |
576 |
$21K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,442 |
1,441 |
$18K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
289 |
289 |
$16K |
| D4910 |
|
181 |
181 |
$14K |
| D9430 |
|
149 |
144 |
$5K |
| D0220 |
Intraoral - periapical first radiographic image |
163 |
161 |
$2K |
| D1351 |
Sealant - per tooth |
31 |
12 |
$682.00 |