RANCH ACRES FAMILY DENTISTRY PC
NPI: 1174754238
· TULSA, OK 74135
· Dentist
· NPI assigned 08/06/2009
$129K
Total Medicaid Paid
Provider Details
| Authorized Official | WOOD, GARY (DENTIST) |
| NPI Enumeration Date | 08/06/2009 |
Related Entities
Other providers sharing the same authorized official: WOOD, GARY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
237 |
$8K |
| 2022 |
1,267 |
$43K |
| 2023 |
1,089 |
$39K |
| 2024 |
1,046 |
$38K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,642 |
1,642 |
$80K |
| D0120 |
Periodic oral evaluation - established patient |
1,685 |
1,685 |
$38K |
| D0274 |
Bitewings - four radiographic images |
283 |
283 |
$9K |
| D0210 |
Intraoral - complete series of radiographic images |
14 |
14 |
$853.72 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
15 |
15 |
$457.50 |