MADDATU DENTAL CORPORATION
NPI: 1962893115
· PANORAMA CITY, CA 91402
· Dentist
· NPI assigned 02/10/2015
$101K
Total Medicaid Paid
Provider Details
| Authorized Official | MADDATU, JONATHAN (DENTIST/ OWNER) |
| NPI Enumeration Date | 02/10/2015 |
Related Entities
Other providers sharing the same authorized official: MADDATU, JONATHAN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
392 |
$17K |
| 2023 |
679 |
$34K |
| 2024 |
723 |
$49K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
422 |
422 |
$28K |
| D1110 |
Prophylaxis - adult |
276 |
276 |
$23K |
| D0210 |
Intraoral - complete series of radiographic images |
336 |
336 |
$16K |
| D2751 |
Crown - porcelain fused to predominantly base metal |
24 |
15 |
$11K |
| D1206 |
Topical application of fluoride varnish |
528 |
522 |
$8K |
| D4341 |
|
90 |
27 |
$6K |
| D0120 |
Periodic oral evaluation - established patient |
50 |
50 |
$3K |
| D4910 |
|
25 |
25 |
$2K |
| D2954 |
|
18 |
14 |
$2K |
| D1120 |
Prophylaxis - child |
13 |
13 |
$525.00 |
| D0274 |
Bitewings - four radiographic images |
12 |
12 |
$216.00 |