Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › OK › PRYOR › MARK R DOHERTY DDS PC

MARK R DOHERTY DDS PC

NPI: 1285147694 · PRYOR, OK 74361 · Dental Clinic/Center · NPI assigned 11/07/2017

$2K
Total Medicaid Paid
127
Total Claims
127
Beneficiaries
3
Codes Billed
2018-01
First Month
2018-07
Last Month

Provider Details

Authorized OfficialDOHERTY, MARK (OWNER)
NPI Enumeration Date11/07/2017

Related Entities

Other providers sharing the same authorized official: DOHERTY, MARK

ProviderCityStateTotal Paid
COMMONWEALTH MOBILE ORAL HEALTH SERVICES, LLC LAKEVILLE MA $5.04M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 127 $2K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1208 Topical application of fluoride, excluding varnish 80 80 $1K
D1110 Prophylaxis - adult 17 17 $718.93
D0120 Periodic oral evaluation - established patient 30 30 $592.20