Medicaid Provider Spending

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

NPI: 1104348150 · STANTON, CA 90680 · Dentist · NPI assigned 07/12/2017

$38K
Total Medicaid Paid
1,087
Total Claims
573
Beneficiaries
7
Codes Billed
2018-03
First Month
2021-10
Last Month

Provider Details

Authorized OfficialBOONE, THOMAS (DENTIST)
NPI Enumeration Date07/12/2017

Related Entities

Other providers sharing the same authorized official: BOONE, THOMAS

ProviderCityStateTotal Paid
CHEWELAH ASSOCIATED PHYSICIANS PS CHEWELAH WA $3.62M
THOMAS BOONE TUSTIN CA $492K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 303 $3K
2019 167 $21K
2020 452 $13K
2021 165 $986.50

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D8670 Periodic orthodontic treatment visit 92 92 $27K
D0150 Comprehensive oral evaluation - new or established patient 71 71 $4K
D0230 Intraoral - periapical each additional radiographic image 660 146 $3K
D1208 Topical application of fluoride, excluding varnish 186 186 $2K
D1120 Prophylaxis - child 38 38 $1K
D0120 Periodic oral evaluation - established patient 14 14 $630.00
D0274 Bitewings - four radiographic images 26 26 $489.60