Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › LA › MARRERO › EXCEPTIONAL DENTAL OF MARRERO

EXCEPTIONAL DENTAL OF MARRERO

NPI: 1134284789 · MARRERO, LA 70072 · General Practice Dentistry · NPI assigned 12/26/2006

$5K
Total Medicaid Paid
169
Total Claims
113
Beneficiaries
5
Codes Billed
2020-07
First Month
2022-09
Last Month

Provider Details

Authorized OfficialBOURG, DARRELL (DENTIST)
NPI Enumeration Date12/26/2006

Related Entities

Other providers sharing the same authorized official: BOURG, DARRELL

ProviderCityStateTotal Paid
EXCEPTIONAL DENTAL OF KENNER KENNER LA $28K
EXCEPTIONAL DENTAL OF METAIRIE, LLC METAIRIE LA $9K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2020 45 $1K
2022 124 $3K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0150 Comprehensive oral evaluation - new or established patient 69 40 $2K
D0210 Intraoral - complete series of radiographic images 55 28 $1K
D1110 Prophylaxis - adult 17 17 $816.17
D0120 Periodic oral evaluation - established patient 14 14 $381.36
D0272 Bitewings - two radiographic images 14 14 $192.87