Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › OH › NEWARK › PROFESSIONAL DENTAL ALLIANCE OF NEWARK, LLC

PROFESSIONAL DENTAL ALLIANCE OF NEWARK, LLC

NPI: 1740754894 · NEWARK, OH 43055 · Dentist · NPI assigned 01/11/2019

$10K
Total Medicaid Paid
165
Total Claims
129
Beneficiaries
5
Codes Billed
2024-09
First Month
2024-11
Last Month

Provider Details

Authorized OfficialKURTZ, AMANDA (LEAD CREDENTIALING SPECIALIST)
NPI Enumeration Date01/11/2019

Related Entities

Other providers sharing the same authorized official: KURTZ, AMANDA

ProviderCityStateTotal Paid
PROFESSIONAL DENTAL ALLIANCE, LLC MIDDLEBURG HEIGHTS OH $54.17M
PROFESSIONAL DENTAL ALLIANCE OF WARREN, LLC WARREN OH $2.51M
PROFESSIONAL DENTAL ALLIANCE OF MARTINS FERRY, LLC BELLAIRE OH $2.48M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2024 165 $10K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 54 26 $6K
D0150 Comprehensive oral evaluation - new or established patient 63 63 $3K
D0210 Intraoral - complete series of radiographic images 12 12 $1K
D0230 Intraoral - periapical each additional radiographic image 20 12 $175.96
D0220 Intraoral - periapical first radiographic image 16 16 $163.67