Medicaid Provider Spending

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

INGLESIDE FAMILY DENTAL, LLC

NPI: 1174159248 · LADSON, SC 29456 · General Practice Dentistry · NPI assigned 03/20/2020

$3K
Total Medicaid Paid
169
Total Claims
161
Beneficiaries
4
Codes Billed
2022-04
First Month
2024-06
Last Month

Provider Details

Authorized OfficialMATHEW, MARILYN (OWNER)
NPI Enumeration Date03/20/2020

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2022 13 $149.28
2024 156 $3K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0150 Comprehensive oral evaluation - new or established patient 42 42 $2K
D0220 Intraoral - periapical first radiographic image 76 74 $931.19
D0274 Bitewings - four radiographic images 14 14 $380.16
D0230 Intraoral - periapical each additional radiographic image 37 31 $345.68