Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

DRS BROCK, HENDERSON, DI PRISCO, RAVELO AND GREEN INC

NPI: 1194364398 · BECKLEY, WV 25801 · Oral and Maxillofacial Surgery (Dentist) · NPI assigned 01/06/2020

$18K
Total Medicaid Paid
246
Total Claims
204
Beneficiaries
4
Codes Billed
2020-07
First Month
2021-09
Last Month

Provider Details

Authorized OfficialCOYNER, LESLEY (CREDENTIALING)
NPI Enumeration Date01/06/2020

Related Entities

Other providers sharing the same authorized official: COYNER, LESLEY

ProviderCityStateTotal Paid
DRS BROCK, HENDERSON, DI PRISCO, RAVELO AND GREEN INC HUNTINGTON WV $2.15M
DRS BROCK, HENDERSON, DI PRISCO, RAVELO AND GREEN INC CHARLESTON WV $974K
DRS BROCK, HENDERSON, DI PRISCO, RAVELO AND GREEN INC BECKLEY WV $789K
DRS BROCK, HENDERSON, DI PRISCO, RAVELO AND GREEN INC PARKERSBURG WV $582K
DRS BROCK, HENDERSON, DI PRISCO, RAVELO AND GREEN INC HURRICANE WV $534K
DRS BROCK, HENDERSON, DI PRISCO, RAVELO AND GREEN INC CHARLESTON WV $467K
DRS BROCK, HENDERSON, DI PRISCO, RAVELO AND GREEN INC CHARLESTON WV $179K
INDIAN LAND ORAL & FACIAL SURGERY LLC FORT MILL SC $20K
DRS BROCK, HENDERSON, DI PRISCO, RAVELO AND GREEN INC PRINCETON WV $18K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2020 174 $15K
2021 72 $3K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D7210 Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth 51 13 $8K
D9222 32 32 $4K
D0140 Limited oral evaluation - problem focused 113 110 $4K
D0330 Panoramic radiographic image 50 49 $2K