OAK GROVE DENTAL
NPI: 1225338593
· OAK GROVE, LA 71263
· General Practice Dentistry
· NPI assigned 11/02/2010
$168K
Total Medicaid Paid
Provider Details
Related Entities
Other providers sharing the same authorized official: COSTELLO, ROBERT
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,744 |
$57K |
| 2019 |
2,195 |
$66K |
| 2020 |
1,245 |
$36K |
| 2021 |
223 |
$8K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
381 |
241 |
$32K |
| D0120 |
Periodic oral evaluation - established patient |
1,118 |
1,102 |
$29K |
| D1120 |
Prophylaxis - child |
769 |
757 |
$25K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,059 |
1,046 |
$20K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
566 |
508 |
$19K |
| D0272 |
Bitewings - two radiographic images |
911 |
896 |
$18K |
| D1110 |
Prophylaxis - adult |
330 |
325 |
$15K |
| D0330 |
Panoramic radiographic image |
102 |
102 |
$6K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
56 |
53 |
$2K |
| D2140 |
|
20 |
13 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
95 |
79 |
$1K |