SEASONS SAGE
NPI: 1972085660
· CHINO VALLEY, AZ 86323
· Dental Clinic/Center
· NPI assigned 08/30/2018
Provider Details
| Authorized Official | FRAUSTO, DAVID (OWNER) |
| NPI Enumeration Date | 08/30/2018 |
Related Entities
Other providers sharing the same authorized official: FRAUSTO, DAVID
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
67 |
$2K |
| 2023 |
180 |
$4K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
18 |
12 |
$1K |
| D1110 |
Prophylaxis - adult |
29 |
29 |
$1K |
| D1208 |
Topical application of fluoride, excluding varnish |
49 |
48 |
$832.31 |
| D0120 |
Periodic oral evaluation - established patient |
32 |
32 |
$822.62 |
| D0210 |
Intraoral - complete series of radiographic images |
12 |
12 |
$726.48 |
| D0220 |
Intraoral - periapical first radiographic image |
59 |
55 |
$696.30 |
| D0274 |
Bitewings - four radiographic images |
16 |
16 |
$478.99 |
| D0230 |
Intraoral - periapical each additional radiographic image |
32 |
17 |
$344.59 |