Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › WA › PORT ORCHARD › PORT ORCHARD DENTAL LLC

PORT ORCHARD DENTAL LLC

NPI: 1538732144 · PORT ORCHARD, WA 98366 · Dentist · NPI assigned 07/21/2021

$7K
Total Medicaid Paid
298
Total Claims
231
Beneficiaries
5
Codes Billed
2021-11
First Month
2022-01
Last Month

Provider Details

Authorized OfficialPROBST, TRAVIS (DENTIST/OWNER)
NPI Enumeration Date07/21/2021

Related Entities

Other providers sharing the same authorized official: PROBST, TRAVIS

ProviderCityStateTotal Paid
BONNEY LAKE DENTAL LLC BONNEY LAKE WA $4.81M
FAIRWOOD PEDODONTICSLLC RENTON WA $1.33M
FAIRWOOD DENTAL LLC RENTON WA $1.20M
LAKE MERIDIAN DENTAL LLC KENT WA $435K
PUYALLUP DENTAL, LLC PUYALLUP WA $84K
NORTH LAKEWOOD DENTAL PLCC LAKEWOOD WA $30K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2021 223 $5K
2022 75 $2K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0150 Comprehensive oral evaluation - new or established patient 114 85 $3K
D0140 Limited oral evaluation - problem focused 50 47 $2K
D0210 Intraoral - complete series of radiographic images 45 26 $1K
D0220 Intraoral - periapical first radiographic image 50 48 $502.24
D0230 Intraoral - periapical each additional radiographic image 39 25 $90.75