ANGELA GRAY FAMILY DENTISTRY INC.
NPI: 1629215983
· JACKSONVILLE, AR 72076
· Dentist
· NPI assigned 01/08/2009
$301K
Total Medicaid Paid
Provider Details
| Authorized Official | GRAY, ANGELA (DENTIST) |
| NPI Enumeration Date | 01/08/2009 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
4,425 |
$103K |
| 2019 |
2,681 |
$58K |
| 2020 |
1,827 |
$41K |
| 2021 |
1,189 |
$28K |
| 2022 |
1,409 |
$29K |
| 2023 |
1,045 |
$25K |
| 2024 |
759 |
$18K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,659 |
1,224 |
$74K |
| D0120 |
Periodic oral evaluation - established patient |
2,457 |
1,794 |
$60K |
| D0272 |
Bitewings - two radiographic images |
2,209 |
1,596 |
$47K |
| D1206 |
Topical application of fluoride varnish |
2,163 |
1,515 |
$42K |
| D0220 |
Intraoral - periapical first radiographic image |
2,098 |
1,474 |
$36K |
| D0230 |
Intraoral - periapical each additional radiographic image |
2,049 |
1,444 |
$28K |
| D1120 |
Prophylaxis - child |
377 |
234 |
$12K |
| D0601 |
|
184 |
151 |
$901.66 |
| D1208 |
Topical application of fluoride, excluding varnish |
29 |
26 |
$425.44 |
| D0602 |
|
66 |
57 |
$305.08 |
| D1999 |
|
44 |
42 |
$0.00 |