SERGIO PEREIRA & SIMONNE PATRICK, DDS A PROF CORP
NPI: 1972038321
· ELK GROVE, CA 95757
· General Practice Dentistry
· NPI assigned 04/24/2017
$975.00
Total Medicaid Paid
Provider Details
| Authorized Official | PEREIRA, SERGIO (PRESIDENT) |
| NPI Enumeration Date | 04/24/2017 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
26 |
$975.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0210 |
Intraoral - complete series of radiographic images |
13 |
13 |
$520.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
13 |
13 |
$455.00 |