ONYEKABA, MICHAEL

$2K

Total Medicaid Paid

9,621

Total Claims

8,382

Beneficiaries

22

Codes Billed

2018-01

First Month

2018-09

Last Month

Year	Claims	Total Paid
2018	9,621	$2K

Code	Description	Claims	Beneficiaries	Total Paid
D7140	Extraction, erupted tooth or exposed root	438	231	$632.06
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	541	319	$365.90
D0140	Limited oral evaluation - problem focused	496	476	$215.91
D0330	Panoramic radiographic image	566	566	$183.48
D0220	Intraoral - periapical first radiographic image	1,039	945	$114.90
D0150	Comprehensive oral evaluation - new or established patient	700	698	$94.19
D0274	Bitewings - four radiographic images	802	800	$83.84
D0230	Intraoral - periapical each additional radiographic image	1,221	746	$81.67
D1110	Prophylaxis - adult	477	477	$68.18
D2393	Resin-based composite - three surfaces, posterior, primary or permanent	188	141	$65.20
D2391	Resin-based composite - one surface, posterior, primary or permanent	160	126	$41.86
D4355		213	213	$34.09
D0120	Periodic oral evaluation - established patient	731	731	$31.38
D0272	Bitewings - two radiographic images	297	296	$21.84
D1206	Topical application of fluoride varnish	688	687	$17.98
D1120	Prophylaxis - child	433	432	$0.00
D5225		14	13	$0.00
D0270		38	38	$0.00
D1330		375	375	$0.00
D2331		46	31	$0.00
D5226		27	27	$0.00
D1351	Sealant - per tooth	131	14	$0.00

Medicaid Provider Spending