Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › CO › BOULDER › JACKSON, STACY

JACKSON, STACY

NPI: 1043530991 · BOULDER, CO 80301 · Dentist · NPI assigned 06/02/2010

$576.00
Total Medicaid Paid
12
Total Claims
12
Beneficiaries
1
Codes Billed
2021-07
First Month
2021-07
Last Month

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2021 12 $576.00

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1120 Prophylaxis - child 12 12 $576.00