THREE MILE DENTISTRY, PLLC
NPI: 1699149518
· MISSION, TX 78573
· General Practice Dentistry
· NPI assigned 11/16/2015
$212K
Total Medicaid Paid
Provider Details
| Authorized Official | NANVA, HARJAP (MEMBER) |
| NPI Enumeration Date | 11/16/2015 |
Related Entities
Other providers sharing the same authorized official: NANVA, HARJAP
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
122 |
$2K |
| 2021 |
2,194 |
$53K |
| 2022 |
2,536 |
$62K |
| 2023 |
2,325 |
$52K |
| 2024 |
1,879 |
$44K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1351 |
Sealant - per tooth |
2,440 |
553 |
$65K |
| D0120 |
Periodic oral evaluation - established patient |
1,031 |
1,023 |
$29K |
| D1120 |
Prophylaxis - child |
777 |
772 |
$28K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,504 |
1,493 |
$22K |
| D1110 |
Prophylaxis - adult |
389 |
388 |
$21K |
| D0274 |
Bitewings - four radiographic images |
256 |
254 |
$9K |
| D0210 |
Intraoral - complete series of radiographic images |
119 |
119 |
$8K |
| D0145 |
Oral evaluation for a patient under three years of age |
56 |
56 |
$8K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
91 |
57 |
$7K |
| D0272 |
Bitewings - two radiographic images |
310 |
309 |
$7K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
190 |
188 |
$7K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
12 |
12 |
$325.32 |
| D0350 |
|
14 |
13 |
$238.94 |
| D0603 |
|
1,867 |
1,838 |
$0.00 |