RED SQUARE DENTAL & ORTHODONTICS AT CLOSNER PLLC

NPI: 1043907702 · EDINBURG, TX 78539 · General Practice Dentistry · NPI assigned 04/21/2023

$9K

Total Medicaid Paid

561

Total Claims

539

Beneficiaries

Codes Billed

2024-06

First Month

2024-11

Last Month

Provider Details

Authorized Official	LOSHKAREV, VLADISLAV (DENTIST/OWNER)
NPI Enumeration Date	04/21/2023

Other providers sharing the same authorized official: LOSHKAREV, VLADISLAV

Provider	City	State	Total Paid
RIO GRANDE CITY PEDIATRIC DENTISTRY PLLC	RIO GRANDE CITY	TX	$2.87M
CORNERSTONE COSMETIC & FAMILY DENTISTRY	EDINBURG	TX	$1.95M
RED SQUARE DENTAL	EDINBURG	TX	$1.06M

Year	Claims	Total Paid
2024	561	$9K

Code	Description	Claims	Beneficiaries	Total Paid
D0150	Comprehensive oral evaluation - new or established patient	84	83	$3K
D1110	Prophylaxis - adult	31	31	$1K
D1208	Topical application of fluoride, excluding varnish	102	100	$1K
D0274	Bitewings - four radiographic images	30	30	$941.42
D0330	Panoramic radiographic image	21	21	$800.04
D0230	Intraoral - periapical each additional radiographic image	76	64	$572.95
D0220	Intraoral - periapical first radiographic image	70	68	$561.28
D1120	Prophylaxis - child	14	14	$514.50
D0272	Bitewings - two radiographic images	13	13	$203.87
D0603		120	115	$0.00