Medicaid Provider Spending

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

LC ELITE PLLC

NPI: 1487256392 · LEAGUE CITY, TX 77573 · Dentist · NPI assigned 11/15/2020

$8K
Total Medicaid Paid
707
Total Claims
592
Beneficiaries
9
Codes Billed
2022-03
First Month
2024-12
Last Month

Provider Details

Authorized OfficialADEGUN, OREOLUWA (GENERAL DENTIST)
NPI Enumeration Date11/15/2020

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2022 46 $470.57
2023 185 $2K
2024 476 $6K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1206 Topical application of fluoride varnish 196 166 $2K
D1120 Prophylaxis - child 56 50 $2K
D0150 Comprehensive oral evaluation - new or established patient 45 39 $1K
D0120 Periodic oral evaluation - established patient 70 56 $1K
D0220 Intraoral - periapical first radiographic image 156 121 $1K
D0230 Intraoral - periapical each additional radiographic image 86 66 $736.64
D0274 Bitewings - four radiographic images 12 12 $311.49
D0601 73 69 $0.00
D0603 13 13 $0.00