Medicaid Provider Spending

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

MANUEL ROMAN DENTAL CORP

NPI: 1245857887 · BELLFLOWER, CA 90706 · Dental Clinic/Center · NPI assigned 06/30/2020

$28K
Total Medicaid Paid
795
Total Claims
353
Beneficiaries
8
Codes Billed
2020-11
First Month
2022-06
Last Month

Provider Details

Authorized OfficialROMAN, MANUEL (DENTIST /OWNER)
NPI Enumeration Date06/30/2020

Related Entities

Other providers sharing the same authorized official: ROMAN, MANUEL

ProviderCityStateTotal Paid
SUBURBAN EMERGENCY ASSOCIATES, P.A. SHAKOPEE MN $5.24M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2020 340 $13K
2021 431 $14K
2022 24 $997.50

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 92 33 $6K
D0150 Comprehensive oral evaluation - new or established patient 94 94 $6K
D2391 Resin-based composite - one surface, posterior, primary or permanent 95 26 $5K
D2393 Resin-based composite - three surfaces, posterior, primary or permanent 45 24 $4K
D0210 Intraoral - complete series of radiographic images 64 64 $3K
D0350 298 50 $3K
D1206 Topical application of fluoride varnish 50 50 $711.50
D0230 Intraoral - periapical each additional radiographic image 57 12 $230.85