ISMILE DENTAL AT LA GRAN PLAZA, PLLC
NPI: 1629329891
· FORT WORTH, TX 76115
· 122300000X
$1.41M
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
990 |
$53K |
| 2021 |
9,846 |
$332K |
| 2022 |
10,372 |
$336K |
| 2023 |
11,195 |
$357K |
| 2024 |
10,032 |
$335K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D2392 |
|
5,335 |
1,724 |
$524K |
| D2391 |
|
2,127 |
764 |
$153K |
| D0145 |
|
843 |
836 |
$116K |
| D0230 |
|
9,570 |
3,051 |
$106K |
| D0120 |
|
3,165 |
3,139 |
$89K |
| D1120 |
|
2,439 |
2,422 |
$87K |
| D1110 |
|
1,228 |
1,216 |
$65K |
| D1208 |
|
4,039 |
4,007 |
$58K |
| D9230 |
|
1,532 |
1,476 |
$41K |
| D0220 |
|
3,282 |
3,245 |
$40K |
| D0274 |
|
995 |
982 |
$33K |
| D0210 |
|
464 |
459 |
$31K |
| D0272 |
|
980 |
976 |
$23K |
| D0150 |
|
548 |
542 |
$18K |
| D2330 |
|
182 |
64 |
$13K |
| D1352 |
|
214 |
77 |
$7K |
| D2393 |
|
51 |
29 |
$6K |
| D1351 |
|
138 |
41 |
$4K |
| D0603 |
|
5,303 |
5,228 |
$0.00 |