POLANCO DENTAL P.C.
NPI: 1972775047
· NEW YORK, NY 10040
· General Practice Dentistry
· NPI assigned 03/29/2008
$713K
Total Medicaid Paid
Provider Details
| Authorized Official | SALCEDO, CARMEN (PRESIDENT) |
| NPI Enumeration Date | 03/29/2008 |
Related Entities
Other providers sharing the same authorized official: SALCEDO, CARMEN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
2,574 |
$191K |
| 2019 |
2,849 |
$178K |
| 2020 |
3,068 |
$205K |
| 2021 |
2,141 |
$139K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
1,456 |
1,151 |
$379K |
| D2332 |
|
694 |
610 |
$129K |
| D1110 |
Prophylaxis - adult |
1,708 |
1,699 |
$72K |
| D0120 |
Periodic oral evaluation - established patient |
1,801 |
1,792 |
$40K |
| D0274 |
Bitewings - four radiographic images |
1,354 |
1,351 |
$30K |
| D0220 |
Intraoral - periapical first radiographic image |
1,582 |
1,578 |
$14K |
| D2394 |
|
83 |
56 |
$13K |
| D2335 |
|
54 |
45 |
$10K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,557 |
1,554 |
$9K |
| D0210 |
Intraoral - complete series of radiographic images |
158 |
158 |
$6K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
50 |
44 |
$5K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
121 |
121 |
$3K |
| D1120 |
Prophylaxis - child |
14 |
14 |
$546.27 |