Medicaid Provider Spending

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

ADVANCED DENTAL CENTER, PLLC

NPI: 1417714809 · FEDERAL HEIGHTS, CO 80260 · General Practice Dentistry · NPI assigned 03/01/2024

$50K
Total Medicaid Paid
1,148
Total Claims
1,123
Beneficiaries
9
Codes Billed
2024-07
First Month
2024-12
Last Month

Provider Details

Authorized OfficialLYDIATT, JOHN (OWNER)
NPI Enumeration Date03/01/2024

Related Entities

Other providers sharing the same authorized official: LYDIATT, JOHN

ProviderCityStateTotal Paid
SUMMIT SMILES PLLC CENTENNIAL CO $525K
SUMMIT SMILES PLLC FEDERAL HEIGHTS CO $179K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2024 1,148 $50K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1110 Prophylaxis - adult 213 210 $19K
D0120 Periodic oral evaluation - established patient 234 229 $9K
D0150 Comprehensive oral evaluation - new or established patient 76 76 $5K
D0220 Intraoral - periapical first radiographic image 295 289 $4K
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 23 16 $3K
D0210 Intraoral - complete series of radiographic images 34 34 $3K
D0140 Limited oral evaluation - problem focused 53 52 $3K
D0274 Bitewings - four radiographic images 77 76 $2K
D0230 Intraoral - periapical each additional radiographic image 143 141 $2K