AVONDALE HILLS DENTAL
NPI: 1912963125
· AVONDALE, AZ 85323
· General Practice Dentistry
· NPI assigned 04/25/2006
$102.56
Total Medicaid Paid
Provider Details
| Authorized Official | ACUFF, JASON (OWNER) |
| NPI Enumeration Date | 04/25/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
25 |
$0.00 |
| 2021 |
67 |
$102.56 |
| 2022 |
14 |
$0.00 |
| 2024 |
12 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0274 |
Bitewings - four radiographic images |
13 |
13 |
$34.28 |
| D0120 |
Periodic oral evaluation - established patient |
14 |
14 |
$29.74 |
| D0220 |
Intraoral - periapical first radiographic image |
79 |
78 |
$26.31 |
| D0230 |
Intraoral - periapical each additional radiographic image |
12 |
12 |
$12.23 |