LA COSTA OF BEAUMONT PA

NPI: 1821446055 · BEAUMONT, TX 77701 · General Practice Dentistry · NPI assigned 05/27/2016

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

Authorized official PHAN, TIEN controls 20+ related entities in our dataset. Read more

$650K

Total Medicaid Paid

23,650

Total Claims

18,031

Beneficiaries

Codes Billed

2020-11

First Month

2024-08

Last Month

Provider Details

Authorized Official	PHAN, TIEN (DENTIST)
NPI Enumeration Date	05/27/2016

Other providers sharing the same authorized official: PHAN, TIEN

Provider	City	State	Total Paid
ACCESS DENTAL OF RUNDBERG	AUSTIN	TX	$3.69M
ACCESS DENTAL OF ED BLUESTEIN PA	AUSTIN	TX	$2.50M
ACCESS DENTAL OF WILLIAM CANNON PA	AUSTIN	TX	$1.69M
LA COSTA DENTAL OF KOSTORYZ PA	CORPUS CHRISTI	TX	$1.62M
LA COSTA DENTAL OF LEOPARD PA	CORPUS CHRISTI	TX	$1.32M
ACCESS DENTAL OF ZARZAMORA PA	SAN ANTONIO	TX	$1.17M
LA COSTA DENTAL OF AYERS PA	CORPUS CHRISTI	TX	$1.11M
ACCESS DENTAL OF 7TH STREET	AUSTIN	TX	$1.06M
ACCESS DENTAL OF WHITE, P.A.	SAN ANTONIO	TX	$564K
ACCESS DENTAL OF MEADOWBROOK	FORT WORTH	TX	$549K
LA COSTA OF PORT ARTHUR PA	PORT ARTHUR	TX	$526K
ACCESS DENTAL OF PLEASANTON, P.A.	SAN ANTONIO	TX	$377K
ACCESS DENTAL OF FREDERICKSBURG PA	SAN ANTONIO	TX	$356K
ACCESS DENTAL OF TRAWOOD PLLC	EL PASO	TX	$349K
ACCESS DENTAL OF VALLEY MILLS PA	WACO	TX	$291K
ACCESS DENTAL OF SAGINAW	SAGINAW	TX	$281K
ACCESS DENTAL OF PARK LAKE PA	WACO	TX	$209K
ACCESS DENTAL OF HALTOM CITY	HALTOM CITY	TX	$140K
ACCESS DENTAL OF EL PASO PLLC	EL PASO	TX	$122K
ACCESS DENTAL OF LAKE JUNE	DALLAS	TX	$115K

Code	Description	Claims	Beneficiaries	Total Paid
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	1,300	451	$112K
D1351	Sealant - per tooth	4,442	795	$101K
D0145	Oral evaluation for a patient under three years of age	658	654	$87K
D0120	Periodic oral evaluation - established patient	2,386	2,327	$63K
D1120	Prophylaxis - child	1,888	1,869	$63K
D1208	Topical application of fluoride, excluding varnish	2,608	2,568	$35K
D2391	Resin-based composite - one surface, posterior, primary or permanent	571	225	$35K
D1110	Prophylaxis - adult	646	627	$30K
D0274	Bitewings - four radiographic images	1,015	972	$27K
D0150	Comprehensive oral evaluation - new or established patient	799	774	$25K
D0210	Intraoral - complete series of radiographic images	254	246	$13K
D0272	Bitewings - two radiographic images	551	546	$12K
D0230	Intraoral - periapical each additional radiographic image	1,160	824	$11K
D0220	Intraoral - periapical first radiographic image	979	958	$10K
D2930	Prefabricated stainless steel crown - primary tooth	83	20	$10K
D2393	Resin-based composite - three surfaces, posterior, primary or permanent	87	44	$7K
D9230	Inhalation of nitrous oxide / analgesia, anxiolysis	205	198	$4K
D0330	Panoramic radiographic image	107	101	$2K
D0140	Limited oral evaluation - problem focused	32	28	$612.29
D0350		28	28	$336.94
D0603		2,697	2,642	$0.67
D0602		901	890	$0.19
D0601		253	244	$0.02