Medicaid Provider Spending

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

FIRST CHAIR DENTISTRY FOR PEDIATRICS AND ADOLESCENTS

NPI: 1114597994 · BURTONSVILLE, MD 20866 · Dental Clinic/Center · NPI assigned 06/25/2021

$59K
Total Medicaid Paid
2,046
Total Claims
1,986
Beneficiaries
9
Codes Billed
2022-09
First Month
2024-10
Last Month

Provider Details

Authorized OfficialELLINGTON, LATAVIAS (DENTIST)
NPI Enumeration Date06/25/2021

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2022 13 $732.42
2023 817 $23K
2024 1,216 $35K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1120 Prophylaxis - child 459 458 $22K
D1206 Topical application of fluoride varnish 541 540 $14K
D0120 Periodic oral evaluation - established patient 247 247 $8K
D0150 Comprehensive oral evaluation - new or established patient 104 104 $6K
D1351 Sealant - per tooth 70 16 $3K
D0220 Intraoral - periapical first radiographic image 174 172 $2K
D1330 261 261 $2K
D0230 Intraoral - periapical each additional radiographic image 147 145 $2K
D0272 Bitewings - two radiographic images 43 43 $705.63