Medicaid Provider Spending

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

OKC 89TH DENTAL, PLLC

NPI: 1215470497 · OKLAHOMA CITY, OK 73139 · General Practice Dentistry · NPI assigned 11/21/2016

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official CARDON, CREED controls 20+ related entities in our dataset. Read more

$962K
Total Medicaid Paid
29,539
Total Claims
25,704
Beneficiaries
20
Codes Billed
2021-10
First Month
2024-12
Last Month

Provider Details

Authorized OfficialCARDON, CREED (OWNER)
NPI Enumeration Date11/21/2016

Related Entities

Other providers sharing the same authorized official: CARDON, CREED

ProviderCityStateTotal Paid
MCO PEDS PLLC JENKS OK $2.51M
OKLAHOMA CITY DENTAL SW, PLLC OKLAHOMA CITY OK $1.24M
SUMMER DENTAL STILLWATER, PLLC STILLWATER OK $1.22M
SAPULPA KIDS DENTAL PLLC SAPULPA OK $1.12M
SPRING ORTHODONTICS TULSA TULSA OK $1.03M
SPRING DENTAL COLLINSVILLE, PLLC COLLINSVILLE OK $1.01M
TULSA KIDS DENTAL PLLC TULSA OK $857K
WITCHITA 21ST DENTAL, PA WICHITA KS $802K
SUMMER DENTAL MIDWEST CITY, PLLC MIDWEST CITY OK $454K
SPRING DENTAL VINITA, PLLC VINITA OK $371K
RIVER DENTAL SILOAM SPRINGS, PLLC SILOAM SPRINGS AR $267K
ELITE ORAL AND MAXILLOFACIAL SURGERY OF OKLAHOMA, PLLC TULSA OK $194K
COTTONWOOD DENTAL MAIZE, PA WICHITA KS $186K
REDBUD DENTAL EDMOND, PLLC EDMOND OK $157K
DENTAL CARE OF WICHITA PA WICHITA KS $73K
RIVER DENTAL ROGERS SOUTH, PLLC ROGERS AR $66K
RIVER DENTAL ROGERS, PLLC ROGERS AR $61K
MARION FAMILY SMILES, P.A. MARION KS $56K
OWASSO PEDIATRIC DENTISTRY, PLLC OWASSO OK $45K
WILLOW DENTAL BELLEVUE, LLC BELLEVUE NE $23K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2021 1,736 $37K
2022 9,607 $261K
2023 9,244 $303K
2024 8,952 $361K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D2393 Resin-based composite - three surfaces, posterior, primary or permanent 836 505 $129K
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 964 571 $116K
D1110 Prophylaxis - adult 2,005 1,937 $89K
D1354 1,136 30 $87K
D0220 Intraoral - periapical first radiographic image 4,491 4,355 $67K
D1206 Topical application of fluoride varnish 3,944 3,787 $67K
D0120 Periodic oral evaluation - established patient 3,059 2,944 $64K
D0330 Panoramic radiographic image 1,274 1,247 $61K
D0274 Bitewings - four radiographic images 1,868 1,783 $56K
D1120 Prophylaxis - child 1,694 1,621 $51K
D7210 Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth 398 138 $47K
D0230 Intraoral - periapical each additional radiographic image 4,494 3,926 $34K
D0150 Comprehensive oral evaluation - new or established patient 991 943 $29K
D0350 790 790 $24K
D1351 Sealant - per tooth 591 152 $14K
D0272 Bitewings - two radiographic images 538 538 $10K
D0140 Limited oral evaluation - problem focused 307 303 $9K
D2391 Resin-based composite - one surface, posterior, primary or permanent 74 56 $4K
D2335 19 12 $2K
D9230 Inhalation of nitrous oxide / analgesia, anxiolysis 66 66 $2K