Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › TX › FORT WORTH › ELLIS DENTAL LLC

ELLIS DENTAL LLC

NPI: 1831640044 · FORT WORTH, TX 76164 · General Practice Dentistry · NPI assigned 10/24/2016

$17K
Total Medicaid Paid
802
Total Claims
367
Beneficiaries
8
Codes Billed
2018-08
First Month
2018-12
Last Month

Provider Details

Authorized OfficialPATEL, HIREN (OWNER)
NPI Enumeration Date10/24/2016

Related Entities

Other providers sharing the same authorized official: PATEL, HIREN

ProviderCityStateTotal Paid
TKV HOSPITALITY CORP HICKSVILLE NY $1.48M
KRISHIROSHI, LLC ASHEVILLE NC $79K
HIREN A. PATEL, DDS, PLLC ARLINGTON TX $27K
STADIUM DENTAL PLLC ARLINGTON TX $24K
AZ CHILDREN'S DENTAL CARE PLLC PHOENIX AZ $10K
GALLOWAY DENTAL PLLC MESQUITE TX $1K
HIREN K PATEL MD PC OPELIKA AL $682.64

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 802 $17K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1351 Sealant - per tooth 399 49 $11K
D0230 Intraoral - periapical each additional radiographic image 146 61 $2K
D0274 Bitewings - four radiographic images 32 32 $1K
D0150 Comprehensive oral evaluation - new or established patient 27 27 $953.64
D1208 Topical application of fluoride, excluding varnish 61 61 $896.70
D0220 Intraoral - periapical first radiographic image 61 61 $766.16
D1120 Prophylaxis - child 15 15 $551.25
D0603 61 61 $0.00