CUSTER DENTAL AND ORTHODONTICS, PLLC
NPI: 1205356193
· MCKINNEY, TX 75070
· Dentist
· NPI assigned 06/22/2017
$117K
Total Medicaid Paid
5,951
Beneficiary Records
Provider Details
Related Entities
Other providers sharing the same authorized official: HOUARI, IBRAHIM
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
228 |
$4K |
| 2021 |
1,555 |
$24K |
| 2022 |
2,264 |
$39K |
| 2023 |
2,564 |
$38K |
| 2024 |
955 |
$12K |
Billing Codes
| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| D0230 |
Intraoral - periapical each additional radiographic image |
1,978 |
776 |
$21K |
| D0120 |
Periodic oral evaluation - established patient |
721 |
702 |
$20K |
| D1120 |
Prophylaxis - child |
521 |
512 |
$18K |
| D1110 |
Prophylaxis - adult |
247 |
244 |
$13K |
| D1206 |
Topical application of fluoride varnish |
739 |
726 |
$10K |
| D0220 |
Intraoral - periapical first radiographic image |
857 |
833 |
$10K |
| D1351 |
Sealant - per tooth |
358 |
54 |
$10K |
| D0274 |
Bitewings - four radiographic images |
165 |
161 |
$5K |
| D1208 |
Topical application of fluoride, excluding varnish |
246 |
240 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
81 |
80 |
$3K |
| D0210 |
Intraoral - complete series of radiographic images |
33 |
33 |
$2K |
| D0145 |
Oral evaluation for a patient under three years of age |
12 |
12 |
$2K |
| D0272 |
Bitewings - two radiographic images |
26 |
26 |
$607.88 |
| D0603 |
|
1,582 |
1,552 |
$0.00 |