Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › TN › SMYRNA › EVOLVE DENTAL MEDSPA

EVOLVE DENTAL MEDSPA

NPI: 1164261822 · SMYRNA, TN 37167 · Dentist · NPI assigned 05/22/2024

$4K
Total Medicaid Paid
545
Total Claims
103
Beneficiaries
4
Codes Billed
2024-11
First Month
2024-12
Last Month

Provider Details

Authorized OfficialLANVIN, ALEXA (OFFICE MANAGER)
Parent OrganizationCRYSTAL CLEAR FAMILY DENTISTRY
NPI Enumeration Date05/22/2024

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2024 545 $4K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1354 473 31 $2K
D1110 Prophylaxis - adult 29 29 $1K
D1206 Topical application of fluoride varnish 31 31 $556.20
D0150 Comprehensive oral evaluation - new or established patient 12 12 $214.97