Medicaid Provider Spending

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

TRINITY LAREDO DENTAL PLLC

NPI: 1801497532 · LAREDO, TX 78043 · General Practice Dentistry · NPI assigned 11/09/2020

$14K
Total Medicaid Paid
752
Total Claims
689
Beneficiaries
8
Codes Billed
2022-05
First Month
2024-10
Last Month

Provider Details

Authorized OfficialLOPEZ, RUBEN (DIRECTOR OF OPERATIONS)
NPI Enumeration Date11/09/2020

Related Entities

Other providers sharing the same authorized official: LOPEZ, RUBEN

ProviderCityStateTotal Paid
PORT ORANGE PEDIATRICS P A PORT ORANGE FL $1.28M
TRINITY MAGNOLIA DENTAL PLLC MAGNOLIA TX $199K
TRINITY SPRING DENTAL PLLC SPRING TX $7K
MED ZONE DME LLC RIO GRANDE CITY TX $4K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2022 152 $2K
2023 404 $8K
2024 196 $3K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0150 Comprehensive oral evaluation - new or established patient 96 94 $3K
D1110 Prophylaxis - adult 48 47 $2K
D0274 Bitewings - four radiographic images 68 67 $2K
D0230 Intraoral - periapical each additional radiographic image 203 156 $2K
D0220 Intraoral - periapical first radiographic image 170 161 $2K
D1208 Topical application of fluoride, excluding varnish 103 102 $1K
D0330 Panoramic radiographic image 17 16 $821.94
D0603 47 46 $0.00