CITY DENTAL LLC
NPI: 1972072908
· PHILADELPHIA, PA 19147
· Dental Clinic/Center
· NPI assigned 11/20/2018
Provider Details
| Authorized Official | CHAE, JAE (OWNER) |
| NPI Enumeration Date | 11/20/2018 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
292 |
$5K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
59 |
58 |
$2K |
| D0274 |
Bitewings - four radiographic images |
67 |
66 |
$2K |
| D0120 |
Periodic oral evaluation - established patient |
30 |
30 |
$567.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
68 |
67 |
$498.96 |
| D0220 |
Intraoral - periapical first radiographic image |
68 |
67 |
$498.96 |