LAKE COUNTRY ORTHODONTICS
NPI: 1962013813
· ARDMORE, OK 73401
· Orthodontics and Dentofacial Orthopedic Dentist
· NPI assigned 08/13/2020
$393K
Total Medicaid Paid
Provider Details
| Authorized Official | MILLER, LORI (OFFICE MANAGER) |
| NPI Enumeration Date | 08/13/2020 |
Related Entities
Other providers sharing the same authorized official: MILLER, LORI
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
19 |
$22K |
| 2022 |
225 |
$188K |
| 2023 |
225 |
$168K |
| 2024 |
13 |
$15K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D8080 |
Comprehensive orthodontic treatment of the adolescent dentition |
343 |
343 |
$386K |
| D0340 |
|
63 |
63 |
$4K |
| D9310 |
|
51 |
51 |
$2K |
| D0470 |
|
25 |
25 |
$952.88 |