Medicaid Provider Spending

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

LOUP VALLEY DENTAL

NPI: 1215493390 · ORD, NE 68862 · General Practice Dentistry · NPI assigned 02/14/2019

$14K
Total Medicaid Paid
539
Total Claims
533
Beneficiaries
6
Codes Billed
2023-04
First Month
2023-11
Last Month

Provider Details

Authorized OfficialBRINKMAN, ARIELLE (DOCTOR)
NPI Enumeration Date02/14/2019

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2023 539 $14K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1206 Topical application of fluoride varnish 162 162 $4K
D0120 Periodic oral evaluation - established patient 162 162 $4K
D1110 Prophylaxis - adult 63 63 $2K
D1120 Prophylaxis - child 72 72 $2K
D0274 Bitewings - four radiographic images 25 25 $537.92
D1999 55 49 $370.00