GOMEZ DENTAL SOLUTIONS LLC
NPI: 1932751062
· HOUSTON, TX 77015
· Dental Clinic/Center
· NPI assigned 07/09/2019
$137K
Total Medicaid Paid
Provider Details
| Authorized Official | GOMEZ, HECTOR (OWNER/GENERAL DENTIST) |
| NPI Enumeration Date | 07/09/2019 |
Related Entities
Other providers sharing the same authorized official: GOMEZ, HECTOR
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
131 |
$2K |
| 2021 |
2,022 |
$38K |
| 2022 |
2,191 |
$40K |
| 2023 |
1,915 |
$33K |
| 2024 |
1,452 |
$25K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
738 |
731 |
$21K |
| D1351 |
Sealant - per tooth |
706 |
153 |
$20K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,809 |
1,033 |
$19K |
| D0274 |
Bitewings - four radiographic images |
538 |
536 |
$17K |
| D1120 |
Prophylaxis - child |
418 |
416 |
$15K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,020 |
1,015 |
$15K |
| D0220 |
Intraoral - periapical first radiographic image |
1,079 |
1,069 |
$12K |
| D1110 |
Prophylaxis - adult |
220 |
219 |
$12K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
43 |
24 |
$4K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
61 |
61 |
$2K |
| D0330 |
Panoramic radiographic image |
12 |
12 |
$252.09 |
| D0603 |
|
1,067 |
1,064 |
$45.14 |