Medicaid Provider Spending

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

LOTUS SMILES PLLC

NPI: 1932559366 · MCKINNEY, TX 75070 · General Practice Dentistry · NPI assigned 06/16/2016

$1K
Total Medicaid Paid
77
Total Claims
75
Beneficiaries
5
Codes Billed
2023-06
First Month
2023-06
Last Month

Provider Details

Authorized OfficialPERAVALI, KARUNA (MANAGER)
NPI Enumeration Date06/16/2016

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2023 77 $1K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1110 Prophylaxis - adult 12 12 $548.80
D0274 Bitewings - four radiographic images 12 12 $380.71
D1206 Topical application of fluoride varnish 17 17 $235.20
D0220 Intraoral - periapical first radiographic image 18 17 $163.28
D0230 Intraoral - periapical each additional radiographic image 18 17 $149.63