ELITE DENTAL
NPI: 1942522073
· ALTAMONTE SPRINGS, FL 32714
· General Practice Dentistry
· NPI assigned 02/16/2010
Provider Details
| Authorized Official | OLMOS, RODOLFO (DENTIST) |
| NPI Enumeration Date | 02/16/2010 |
Related Entities
Other providers sharing the same authorized official: OLMOS, RODOLFO
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
14 |
$0.00 |
| 2020 |
548 |
$11K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
110 |
110 |
$7K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
29 |
29 |
$3K |
| D1110 |
Prophylaxis - adult |
40 |
40 |
$677.87 |
| D1120 |
Prophylaxis - child |
95 |
95 |
$474.83 |
| D0330 |
Panoramic radiographic image |
25 |
25 |
$0.00 |
| D1330 |
|
160 |
160 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
103 |
103 |
$0.00 |