ALTIUS DENTAL 2 PLLC

NPI: 1558088351 · KINGSVILLE, TX 78363 · General Practice Dentistry · NPI assigned 10/21/2022

$29K

Total Medicaid Paid

1,728

Total Claims

1,560

Beneficiaries

Codes Billed

2023-11

First Month

2024-11

Last Month

Provider Details

Authorized Official	DHIR, GUNJAN (OWNER)
NPI Enumeration Date	10/21/2022

Other providers sharing the same authorized official: DHIR, GUNJAN

Provider	City	State	Total Paid
LIVINGSTON SMILES PLLC	LIVINGSTON	TX	$1.64M
PAMPA DENTAL PLLC	PAMPA	TX	$1.52M
HEREFORD DENTAL PLLC	HEREFORD	TX	$1.34M
A1 DENTAL PLLC	LAMPASAS	TX	$978K
DENTAL TRENDS PLLC	KERRVILLE	TX	$635K
BURK SMILES PLLC	BURKBURNETT	TX	$272K
1521 W UNIVERSITY RD PLLC	MCKINNEY	TX	$15K

Year	Claims	Total Paid
2023	175	$3K
2024	1,553	$26K

Code	Description	Claims	Beneficiaries	Total Paid
D0274	Bitewings - four radiographic images	179	161	$5K
D1110	Prophylaxis - adult	120	103	$5K
D0120	Periodic oral evaluation - established patient	174	158	$4K
D0220	Intraoral - periapical first radiographic image	332	300	$4K
D1206	Topical application of fluoride varnish	263	251	$3K
D0230	Intraoral - periapical each additional radiographic image	314	262	$3K
D0150	Comprehensive oral evaluation - new or established patient	83	74	$2K
D1120	Prophylaxis - child	48	47	$2K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	14	12	$1K
D0603		119	114	$9.02
D0602		82	78	$0.00