Medicaid Provider Spending

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

PREMIERE DENTISTRY OF TAHLEQUAH

NPI: 1245299825 · TAHLEQUAH, OK 74464 · General Practice Dentistry · NPI assigned 03/21/2006

$15K
Total Medicaid Paid
598
Total Claims
586
Beneficiaries
9
Codes Billed
2021-11
First Month
2021-12
Last Month

Provider Details

Authorized OfficialJONES, ROBERT (DENTIST)
NPI Enumeration Date03/21/2006

Related Entities

Other providers sharing the same authorized official: JONES, ROBERT

ProviderCityStateTotal Paid
GEORGIA PINES COMMUNITY SERVICE BOARD THOMASVILLE GA $45.34M
CALIFORNIA ANESTHESIA ASSOCIATES MEDICAL GROUP, INC. LONG BEACH CA $3.36M
SOUTHWEST INTEGRATIVE HEALTH CENTER, LLC ALBUQUERQUE NM $1.35M
BARBOUR COUNTY EMERGENCY SQUAD INC. PHILIPPI WV $1.16M
COLORADO RIVER FIRE RESCUE RIFLE CO $358K
LONGVIEW ORTHOPAEDIC CENTER, LLC LEOMINSTER MA $269K
ROBERT H JONES DDS PC MCMINNVILLE TN $39K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2021 598 $15K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0120 Periodic oral evaluation - established patient 155 155 $3K
D1120 Prophylaxis - child 94 94 $3K
D1110 Prophylaxis - adult 60 60 $3K
D1208 Topical application of fluoride, excluding varnish 167 167 $2K
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 21 13 $2K
D2391 Resin-based composite - one surface, posterior, primary or permanent 15 12 $914.70
D0220 Intraoral - periapical first radiographic image 41 41 $624.84
D0272 Bitewings - two radiographic images 31 31 $530.70
D9230 Inhalation of nitrous oxide / analgesia, anxiolysis 14 13 $384.16