Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › OR › TIGARD › OREGON MOBILE DENTISTRY, P.C.

OREGON MOBILE DENTISTRY, P.C.

NPI: 1093138893 · TIGARD, OR 97224 · Dentist · NPI assigned 01/29/2014

$109K
Total Medicaid Paid
1,159
Total Claims
995
Beneficiaries
6
Codes Billed
2018-01
First Month
2021-11
Last Month

Provider Details

Authorized OfficialWILLIAMS, GREGORY (CHIEF EXECUTIVE/DENTIST)
NPI Enumeration Date01/29/2014

Related Entities

Other providers sharing the same authorized official: WILLIAMS, GREGORY

ProviderCityStateTotal Paid
WILLIAMS ORAL AND MAXILLOFACIAL SURGERY, PROF. L.L.C. RAPID CITY SD $116K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 370 $37K
2019 219 $14K
2020 100 $10K
2021 470 $47K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D9410 962 806 $100K
D9920 61 54 $5K
D1110 Prophylaxis - adult 26 26 $2K
D1206 Topical application of fluoride varnish 45 45 $1K
D0120 Periodic oral evaluation - established patient 28 27 $766.45
D0220 Intraoral - periapical first radiographic image 37 37 $555.04