GRAND PARKWAY DENTAL PLLC
NPI: 1811387996
· KATY, TX 77450
· General Practice Dentistry
· NPI assigned 01/28/2015
$110K
Total Medicaid Paid
Provider Details
| Authorized Official | GOMEZ, DAVID (GENERAL DENTIST) |
| NPI Enumeration Date | 01/28/2015 |
Related Entities
Other providers sharing the same authorized official: GOMEZ, DAVID
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
861 |
$6K |
| 2021 |
2,252 |
$31K |
| 2022 |
2,098 |
$29K |
| 2023 |
1,998 |
$26K |
| 2024 |
1,302 |
$17K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0230 |
Intraoral - periapical each additional radiographic image |
3,527 |
891 |
$31K |
| D0120 |
Periodic oral evaluation - established patient |
894 |
838 |
$21K |
| D1120 |
Prophylaxis - child |
523 |
496 |
$17K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,155 |
1,089 |
$15K |
| D0220 |
Intraoral - periapical first radiographic image |
989 |
916 |
$10K |
| D1110 |
Prophylaxis - adult |
201 |
190 |
$9K |
| D0274 |
Bitewings - four radiographic images |
113 |
107 |
$3K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
22 |
12 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
25 |
25 |
$734.66 |
| D1999 |
|
24 |
13 |
$0.00 |
| D0602 |
|
793 |
752 |
$0.00 |
| D0603 |
|
245 |
236 |
$0.00 |