EAST TX LLC

NPI: 1144803743 · LONGVIEW, TX 75604 · General Practice Dentistry · NPI assigned 04/30/2021

$43K

Total Medicaid Paid

2,579

Total Claims

2,084

Beneficiaries

Codes Billed

2022-01

First Month

2024-12

Last Month

Provider Details

Authorized Official	NARAYAN, ROHIT (OWNER/DENTIST)
NPI Enumeration Date	04/30/2021

Other providers sharing the same authorized official: NARAYAN, ROHIT

Provider	City	State	Total Paid
817 DENTAL PLLC	CLEBURNE	TX	$1.51M
MINEOLA DENTAL PLLC	MINEOLA	TX	$1.05M
DENTAL ZONE PLLC	JACKSONVILLE	TX	$489K
KEENE DENTAL PLLC	KEENE	TX	$101K
ALTAMESA DENTAL HOME PLLC	FORT WORTH	TX	$40K
CASA DENTAL	DUMAS	TX	$191.10

Code	Description	Claims	Beneficiaries	Total Paid
D0145	Oral evaluation for a patient under three years of age	149	146	$20K
D0230	Intraoral - periapical each additional radiographic image	684	225	$6K
D1120	Prophylaxis - child	116	116	$4K
D0150	Comprehensive oral evaluation - new or established patient	128	127	$4K
D0220	Intraoral - periapical first radiographic image	305	295	$3K
D1208	Topical application of fluoride, excluding varnish	151	151	$2K
D1206	Topical application of fluoride varnish	115	111	$2K
D0120	Periodic oral evaluation - established patient	55	54	$1K
D0272	Bitewings - two radiographic images	61	56	$1K
D0603		815	803	$30.15