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SMILE STOP DENTAL OF SOUTWEST TULSA
SMILE STOP DENTAL OF SOUTWEST TULSA
NPI: 1518414523
· TULSA, OK 74107
· Dental Clinic/Center
· NPI assigned 09/07/2016
$763K
Total Medicaid Paid
Provider Details
| Authorized Official | LARD, JOHN (OWNER/DENTIST) |
| NPI Enumeration Date | 09/07/2016 |
Related Entities
Other providers sharing the same authorized official: LARD, JOHN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
1,212 |
$151K |
| 2022 |
3,609 |
$502K |
| 2023 |
891 |
$109K |
| 2024 |
25 |
$1K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
3,573 |
264 |
$439K |
| D5110 |
|
134 |
134 |
$103K |
| D5120 |
|
73 |
73 |
$57K |
| D5130 |
|
48 |
48 |
$42K |
| D5140 |
|
44 |
44 |
$38K |
| D7140 |
Extraction, erupted tooth or exposed root |
505 |
84 |
$33K |
| D0330 |
Panoramic radiographic image |
435 |
435 |
$22K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
474 |
474 |
$14K |
| D1320 |
|
328 |
328 |
$11K |
| D5411 |
|
74 |
67 |
$3K |
| D5410 |
|
30 |
28 |
$1K |
| D0140 |
Limited oral evaluation - problem focused |
19 |
19 |
$543.50 |