ACE DENTAL07 PLLC
NPI: 1982179743
· HEWITT, TX 76643
· General Practice Dentistry
· NPI assigned 10/09/2018
$192K
Total Medicaid Paid
Provider Details
Related Entities
Other providers sharing the same authorized official: CHAKRAVARTY, ARONAV
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
1,557 |
$19K |
| 2022 |
2,341 |
$38K |
| 2023 |
4,701 |
$82K |
| 2024 |
2,922 |
$53K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0145 |
Oral evaluation for a patient under three years of age |
250 |
249 |
$35K |
| D0230 |
Intraoral - periapical each additional radiographic image |
4,179 |
1,153 |
$30K |
| D1120 |
Prophylaxis - child |
585 |
580 |
$20K |
| D1351 |
Sealant - per tooth |
757 |
96 |
$18K |
| D0120 |
Periodic oral evaluation - established patient |
668 |
660 |
$18K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,136 |
1,122 |
$16K |
| D1110 |
Prophylaxis - adult |
282 |
282 |
$14K |
| D0220 |
Intraoral - periapical first radiographic image |
1,283 |
1,233 |
$12K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
349 |
339 |
$12K |
| D0274 |
Bitewings - four radiographic images |
493 |
484 |
$10K |
| D0210 |
Intraoral - complete series of radiographic images |
139 |
137 |
$6K |
| D0330 |
Panoramic radiographic image |
29 |
28 |
$673.01 |
| D0602 |
|
376 |
375 |
$0.00 |
| D0603 |
|
995 |
985 |
$0.00 |