Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
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UR SMILE DENTAL ON FRY RD PLLC

NPI: 1174230528 · HOUSTON, TX 77084 · Dentist · NPI assigned 11/03/2022

$2K
Total Medicaid Paid
132
Total Claims
119
Beneficiaries
6
Codes Billed
2023-06
First Month
2023-08
Last Month

Provider Details

Authorized OfficialRAVI, PRASHANTH (MEMBER)
Parent OrganizationUR SMILE DENTAL GROUP PLLC
NPI Enumeration Date11/03/2022

Related Entities

Other providers sharing the same authorized official: RAVI, PRASHANTH

ProviderCityStateTotal Paid
GREATER HOUSTON ORAL AND FACIAL SURGERY,PA PASADENA TX $2.71M
GREATER BEAUMONT ORAL & MAXILLOFACIAL SURGERY, PA BEAUMONT TX $187K
UR SMILE DENTAL ON HWY 6 PLLC HOUSTON TX $34K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2023 132 $2K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0120 Periodic oral evaluation - established patient 25 22 $605.85
D1208 Topical application of fluoride, excluding varnish 39 36 $514.50
D1120 Prophylaxis - child 13 13 $477.75
D0220 Intraoral - periapical first radiographic image 20 17 $171.30
D0230 Intraoral - periapical each additional radiographic image 20 17 $126.61
D0602 15 14 $0.00