TRI STATE DENTAL
NPI: 1578153276
· LAS VEGAS, NV 89183
· General Practice Dentistry
· NPI assigned 01/26/2021
$209K
Total Medicaid Paid
Provider Details
| Authorized Official | NGUYEN, BRIAN (OWNER) |
| NPI Enumeration Date | 01/26/2021 |
Related Entities
Other providers sharing the same authorized official: NGUYEN, BRIAN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
2,576 |
$57K |
| 2023 |
3,489 |
$83K |
| 2024 |
2,641 |
$69K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0230 |
Intraoral - periapical each additional radiographic image |
2,012 |
1,664 |
$44K |
| D0140 |
Limited oral evaluation - problem focused |
1,093 |
999 |
$35K |
| D0330 |
Panoramic radiographic image |
573 |
558 |
$19K |
| D0274 |
Bitewings - four radiographic images |
838 |
809 |
$19K |
| D0220 |
Intraoral - periapical first radiographic image |
1,372 |
1,308 |
$16K |
| D1120 |
Prophylaxis - child |
389 |
378 |
$16K |
| D0210 |
Intraoral - complete series of radiographic images |
283 |
274 |
$16K |
| D1206 |
Topical application of fluoride varnish |
467 |
439 |
$13K |
| D0120 |
Periodic oral evaluation - established patient |
707 |
686 |
$11K |
| D1110 |
Prophylaxis - adult |
545 |
526 |
$10K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
363 |
352 |
$9K |
| D0601 |
|
64 |
58 |
$210.00 |