OB DENTAL, LLC
NPI: 1366775140
· TULSA, OK 74120
· General Practice Dentistry
· NPI assigned 09/11/2009
$2.48M
Total Medicaid Paid
Provider Details
Related Entities
Other providers sharing the same authorized official: KEITHLINE, CHARLES
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
2,207 |
$405K |
| 2019 |
1,710 |
$514K |
| 2020 |
1,361 |
$399K |
| 2021 |
1,218 |
$340K |
| 2022 |
1,468 |
$230K |
| 2023 |
1,695 |
$423K |
| 2024 |
902 |
$163K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D8080 |
Comprehensive orthodontic treatment of the adolescent dentition |
1,494 |
1,494 |
$1.92M |
| D9310 |
|
3,242 |
3,233 |
$155K |
| D7240 |
Removal of impacted tooth - completely bony |
661 |
193 |
$136K |
| D0340 |
|
1,910 |
1,905 |
$114K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
246 |
246 |
$54K |
| D0350 |
|
1,734 |
1,734 |
$52K |
| D0330 |
Panoramic radiographic image |
462 |
462 |
$22K |
| D1110 |
Prophylaxis - adult |
221 |
221 |
$9K |
| D9610 |
|
219 |
219 |
$6K |
| D0120 |
Periodic oral evaluation - established patient |
195 |
195 |
$4K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
110 |
110 |
$3K |
| D0274 |
Bitewings - four radiographic images |
67 |
67 |
$2K |