Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

LWL DENTAL GROUP, PLLC

NPI: 1003231242 · KATY, TX 77494 · General Practice Dentistry · NPI assigned 02/25/2014

$10K
Total Medicaid Paid
799
Total Claims
653
Beneficiaries
6
Codes Billed
2020-12
First Month
2021-05
Last Month

Provider Details

Authorized OfficialPETROPOULOS, PAMELA (OFFICE MANAGER)
NPI Enumeration Date02/25/2014

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2020 96 $1K
2021 703 $9K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0230 Intraoral - periapical each additional radiographic image 258 113 $3K
D0120 Periodic oral evaluation - established patient 80 80 $2K
D1208 Topical application of fluoride, excluding varnish 143 143 $2K
D0220 Intraoral - periapical first radiographic image 151 151 $2K
D1120 Prophylaxis - child 33 33 $1K
D0602 134 133 $0.00