LA COSTA DENTAL OF AYERS PA

NPI: 1700204252 · CORPUS CHRISTI, TX 78415 · Dentist · NPI assigned 04/02/2014

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

Authorized official PHAN, TIEN controls 20+ related entities in our dataset. Read more

$1.11M

Total Medicaid Paid

44,793

Total Claims

37,431

Beneficiaries

Codes Billed

2019-04

First Month

2024-12

Last Month

Provider Details

Authorized Official	PHAN, TIEN (DENTIST)
NPI Enumeration Date	04/02/2014

Other providers sharing the same authorized official: PHAN, TIEN

Provider	City	State	Total Paid
ACCESS DENTAL OF RUNDBERG	AUSTIN	TX	$3.69M
ACCESS DENTAL OF ED BLUESTEIN PA	AUSTIN	TX	$2.50M
ACCESS DENTAL OF WILLIAM CANNON PA	AUSTIN	TX	$1.69M
LA COSTA DENTAL OF KOSTORYZ PA	CORPUS CHRISTI	TX	$1.62M
LA COSTA DENTAL OF LEOPARD PA	CORPUS CHRISTI	TX	$1.32M
ACCESS DENTAL OF ZARZAMORA PA	SAN ANTONIO	TX	$1.17M
ACCESS DENTAL OF 7TH STREET	AUSTIN	TX	$1.06M
LA COSTA OF BEAUMONT PA	BEAUMONT	TX	$650K
ACCESS DENTAL OF WHITE, P.A.	SAN ANTONIO	TX	$564K
ACCESS DENTAL OF MEADOWBROOK	FORT WORTH	TX	$549K
LA COSTA OF PORT ARTHUR PA	PORT ARTHUR	TX	$526K
ACCESS DENTAL OF PLEASANTON, P.A.	SAN ANTONIO	TX	$377K
ACCESS DENTAL OF FREDERICKSBURG PA	SAN ANTONIO	TX	$356K
ACCESS DENTAL OF TRAWOOD PLLC	EL PASO	TX	$349K
ACCESS DENTAL OF VALLEY MILLS PA	WACO	TX	$291K
ACCESS DENTAL OF SAGINAW	SAGINAW	TX	$281K
ACCESS DENTAL OF PARK LAKE PA	WACO	TX	$209K
ACCESS DENTAL OF HALTOM CITY	HALTOM CITY	TX	$140K
ACCESS DENTAL OF EL PASO PLLC	EL PASO	TX	$122K
ACCESS DENTAL OF LAKE JUNE	DALLAS	TX	$115K

Code	Description	Claims	Beneficiaries	Total Paid
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	2,070	770	$178K
D1351	Sealant - per tooth	5,437	1,112	$132K
D0120	Periodic oral evaluation - established patient	4,973	4,880	$131K
D1110	Prophylaxis - adult	2,061	2,022	$99K
D1120	Prophylaxis - child	2,774	2,735	$94K
D1208	Topical application of fluoride, excluding varnish	5,316	5,226	$71K
D0145	Oral evaluation for a patient under three years of age	554	550	$70K
D0274	Bitewings - four radiographic images	2,342	2,302	$67K
D2391	Resin-based composite - one surface, posterior, primary or permanent	981	331	$66K
D0210	Intraoral - complete series of radiographic images	917	871	$45K
D0220	Intraoral - periapical first radiographic image	3,147	3,092	$34K
D0230	Intraoral - periapical each additional radiographic image	3,272	2,963	$31K
D0272	Bitewings - two radiographic images	1,133	1,122	$25K
D0150	Comprehensive oral evaluation - new or established patient	688	656	$21K
D2930	Prefabricated stainless steel crown - primary tooth	122	32	$17K
D9230	Inhalation of nitrous oxide / analgesia, anxiolysis	569	548	$11K
D0350		1,012	988	$10K
D0330	Panoramic radiographic image	535	512	$10K
D0140	Limited oral evaluation - problem focused	139	132	$3K
D0603		6,261	6,100	$0.63
D0601		101	99	$0.00
D0602		389	388	$0.00