SIMPLE DENTIST PLLC
NPI: 1215320593
· GRAND PRAIRIE, TX 75052
· General Practice Dentistry
· NPI assigned 03/11/2015
$133K
Total Medicaid Paid
Provider Details
| Authorized Official | NAMINENI, DEEPTI (MANAGING MEMBER) |
| NPI Enumeration Date | 03/11/2015 |
Related Entities
Other providers sharing the same authorized official: NAMINENI, DEEPTI
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
133 |
$2K |
| 2021 |
2,329 |
$39K |
| 2022 |
1,888 |
$26K |
| 2023 |
2,021 |
$31K |
| 2024 |
2,135 |
$35K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0230 |
Intraoral - periapical each additional radiographic image |
2,627 |
1,103 |
$26K |
| D0120 |
Periodic oral evaluation - established patient |
800 |
767 |
$21K |
| D1110 |
Prophylaxis - adult |
340 |
324 |
$17K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,178 |
1,125 |
$16K |
| D0274 |
Bitewings - four radiographic images |
493 |
464 |
$14K |
| D0220 |
Intraoral - periapical first radiographic image |
1,240 |
1,152 |
$13K |
| D1120 |
Prophylaxis - child |
239 |
226 |
$8K |
| D1351 |
Sealant - per tooth |
319 |
39 |
$6K |
| D0145 |
Oral evaluation for a patient under three years of age |
38 |
37 |
$5K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
40 |
13 |
$4K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
92 |
86 |
$3K |
| D0601 |
|
102 |
98 |
$0.00 |
| D0603 |
|
998 |
944 |
$0.00 |