Medicaid Provider Spending

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

RED OAK SMILE CENTER PLLC

NPI: 1396204814 · RED OAK, TX 75154 · General Practice Dentistry · NPI assigned 03/14/2019

$54K
Total Medicaid Paid
4,434
Total Claims
3,455
Beneficiaries
9
Codes Billed
2021-05
First Month
2024-10
Last Month

Provider Details

Authorized OfficialSADEDDIN, KHALID (OWNER)
NPI Enumeration Date03/14/2019

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2021 254 $2K
2022 1,080 $12K
2023 2,060 $27K
2024 1,040 $12K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0120 Periodic oral evaluation - established patient 456 402 $11K
D0230 Intraoral - periapical each additional radiographic image 1,120 497 $10K
D0274 Bitewings - four radiographic images 365 317 $8K
D1110 Prophylaxis - adult 163 135 $6K
D1206 Topical application of fluoride varnish 540 489 $6K
D0220 Intraoral - periapical first radiographic image 607 537 $6K
D1120 Prophylaxis - child 185 174 $6K
D0150 Comprehensive oral evaluation - new or established patient 65 52 $2K
D0603 933 852 $0.00