Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › AZ › LAVEEN › DENTAL AND BRACES LAVEEN

DENTAL AND BRACES LAVEEN

NPI: 1770181042 · LAVEEN, AZ 85339 · Dental Clinic/Center · NPI assigned 10/09/2020

$11K
Total Medicaid Paid
1,006
Total Claims
983
Beneficiaries
7
Codes Billed
2022-09
First Month
2024-11
Last Month

Provider Details

Authorized OfficialRAMOS, ELIZABETH (CREDENTIALING)
NPI Enumeration Date10/09/2020

Related Entities

Other providers sharing the same authorized official: RAMOS, ELIZABETH

ProviderCityStateTotal Paid
DENTAL AND BRACES DYSART LLC AVONDALE AZ $2K
TRANSPORTE CRITICO DEL NORTE SABANA HOYOS PR $2K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2022 63 $1K
2023 122 $2K
2024 821 $8K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D4346 166 166 $3K
D0274 Bitewings - four radiographic images 232 228 $2K
D0220 Intraoral - periapical first radiographic image 378 372 $2K
D0330 Panoramic radiographic image 77 77 $981.25
D0120 Periodic oral evaluation - established patient 84 84 $828.60
D0150 Comprehensive oral evaluation - new or established patient 44 44 $789.39
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 25 12 $598.43