Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › HI › LIHUE › PACIFIC RIM DENTAL GROUP, LLC

PACIFIC RIM DENTAL GROUP, LLC

NPI: 1184089765 · LIHUE, HI 96766 · General Practice Dentistry · NPI assigned 12/23/2015

$9K
Total Medicaid Paid
334
Total Claims
324
Beneficiaries
5
Codes Billed
2018-01
First Month
2020-04
Last Month

Provider Details

Authorized OfficialALLEN, TERRY (DENTIST/OWNER)
NPI Enumeration Date12/23/2015

Related Entities

Other providers sharing the same authorized official: ALLEN, TERRY

ProviderCityStateTotal Paid
ANESTHESIA MEDICAL PROFESSIONALS, PLLC EDMOND OK $305K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 283 $7K
2019 39 $1K
2020 12 $451.20

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0140 Limited oral evaluation - problem focused 156 151 $6K
D0220 Intraoral - periapical first radiographic image 123 118 $2K
D1120 Prophylaxis - child 17 17 $572.56
D0120 Periodic oral evaluation - established patient 15 15 $564.00
D1206 Topical application of fluoride varnish 23 23 $123.51