Medicaid Provider Spending

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

MOUNTAIN VIEW FAMILY DENTISTS LLC

NPI: 1104594878 · RIO RANCHO, NM 87144 · Dental Clinic/Center · NPI assigned 08/30/2021

$10K
Total Medicaid Paid
323
Total Claims
319
Beneficiaries
5
Codes Billed
2023-01
First Month
2023-08
Last Month

Provider Details

Authorized OfficialKEITH, ANACHELICA (MANAGER)
NPI Enumeration Date08/30/2021

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2023 323 $10K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1110 Prophylaxis - adult 88 87 $4K
D0150 Comprehensive oral evaluation - new or established patient 88 87 $3K
D0274 Bitewings - four radiographic images 93 91 $3K
D0220 Intraoral - periapical first radiographic image 40 40 $407.08
D0230 Intraoral - periapical each additional radiographic image 14 14 $117.30