Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

ARCHSTONE DENTAL-GRANBURY PLLC

NPI: 1730484734 · GRANBURY, TX 76048 · Dentist · NPI assigned 01/21/2011

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official PU, MARY controls 20+ related entities in our dataset. Read more

$817K
Total Medicaid Paid
34,351
Total Claims
27,272
Beneficiaries
19
Codes Billed
2020-10
First Month
2024-12
Last Month

Provider Details

Authorized OfficialPU, MARY (CFO)
NPI Enumeration Date01/21/2011

Related Entities

Other providers sharing the same authorized official: PU, MARY

ProviderCityStateTotal Paid
RED ROCK DENTAL-FARMINGTON IRVING TX $3.59M
SAGE DENTAL BAYTOWN TX $2.35M
PEPPERMINT DENTAL-MONTGOMERY LLC ALBUQUERQUE NM $2.14M
SAGE DENTAL-DEER PARK PLLC LA PORTE TX $1.87M
VINH NGO DENTISTRY PLLC VICTORIA TX $1.65M
ELEMENT DENTAL-BRYAN PLLC BRYAN TX $1.57M
FUSION DENTAL IRVING TX $1.49M
ELEMENT DENTAL-CONROE PLLC IRVING TX $1.49M
GULFSIDE DENTAL PORT ARTHUR PLLC PORT ARTHUR TX $1.39M
PEPPERMINT DENTAL-RIO BRAVO LLC ALBUQUERQUE NM $1.29M
FRESH DENTAL-SHREVEPORT IRVING TX $1.27M
FRESH DENTAL-BOSSIER CITY IRVING TX $1.21M
PEPPERMINT DENTAL-SHERMAN PLLC SHERMAN TX $1.17M
ELEMENT DENTAL PLLC LUFKIN TX $1.06M
RIO DENTAL AND ORTHODONTICS LLC RIO RANCHO NM $1.00M
ELEMENT DENTAL-HUMBLE PLLC HUMBLE TX $942K
GULFSIDE DENTAL BEAUMONT TX $939K
LEGEND DENTAL-GEORGETOWN GEORGETOWN TX $919K
BLISS DENTAL PLLC ODESSA TX $827K
BLISS DENTAL LUBBOCK PLLC LUBBOCK TX $826K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2020 1,120 $34K
2021 12,090 $309K
2022 8,858 $211K
2023 7,564 $184K
2024 4,719 $79K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 1,928 979 $189K
D0120 Periodic oral evaluation - established patient 3,741 3,610 $100K
D1110 Prophylaxis - adult 1,808 1,737 $90K
D0230 Intraoral - periapical each additional radiographic image 7,574 3,137 $79K
D1120 Prophylaxis - child 2,129 2,063 $73K
D0274 Bitewings - four radiographic images 1,993 1,913 $63K
D1206 Topical application of fluoride varnish 3,619 3,490 $49K
D0220 Intraoral - periapical first radiographic image 3,473 3,341 $40K
D0210 Intraoral - complete series of radiographic images 623 608 $39K
D1351 Sealant - per tooth 1,101 234 $30K
D0145 Oral evaluation for a patient under three years of age 165 161 $23K
D2391 Resin-based composite - one surface, posterior, primary or permanent 181 113 $14K
D2393 Resin-based composite - three surfaces, posterior, primary or permanent 68 41 $6K
D1208 Topical application of fluoride, excluding varnish 456 443 $6K
D9230 Inhalation of nitrous oxide / analgesia, anxiolysis 231 223 $6K
D0272 Bitewings - two radiographic images 203 202 $5K
D0150 Comprehensive oral evaluation - new or established patient 125 122 $4K
D0140 Limited oral evaluation - problem focused 12 12 $244.27
D0603 4,921 4,843 $99.02