Medicaid Provider Spending

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

TIDEWATER LLC

NPI: 1235642984 · LEXINGTON PARK, MD 20653 · Dentist · NPI assigned 11/15/2017

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official COOPER, DAVID controls 13+ related entities in our dataset. Read more

$735K
Total Medicaid Paid
18,604
Total Claims
17,563
Beneficiaries
14
Codes Billed
2018-10
First Month
2024-12
Last Month

Provider Details

Authorized OfficialCOOPER, DAVID (OWNER)
Parent OrganizationTIDEWATER LLC
NPI Enumeration Date11/15/2017

Related Entities

Other providers sharing the same authorized official: COOPER, DAVID

ProviderCityStateTotal Paid
PROHEALTH CARE ASSOCIATES LLP LAKE SUCCESS NY $69.52M
C H L EMS INC VISALIA CA $10.59M
CHESTER COUNTY PEDIATRICS DOWNINGTON PA $4.85M
STODDARD COUNTY AMBULANCE DISTRICT DEXTER MO $4.67M
DRS. COOPER & BANNINGER, LLC. SALINA KS $587K
NO LIMIT LIFE LLC PENNSAUKEN NJ $366K
TIDEWATER LLC LEXINGTON PARK MD $192K
TIDEWATER LLC SOLOMONS MD $82K
TIDEWATER LLC PRINCE FREDERICK MD $74K
TIDEWATER LLC DUNKIRK MD $21K
TIDEWATER LLC LANHAM MD $21K
MOBILE MEDICAL SERVICES P.C. NEW HYDE PARK NY $3K
CHESTER COUNTY PEDIATRICS PC AVONDALE PA $2K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 343 $10K
2019 3,648 $122K
2020 2,418 $82K
2021 4,003 $162K
2022 4,025 $171K
2023 2,622 $110K
2024 1,545 $78K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 1,166 637 $143K
D1206 Topical application of fluoride varnish 5,811 5,704 $143K
D1120 Prophylaxis - child 2,809 2,772 $120K
D0120 Periodic oral evaluation - established patient 3,689 3,624 $106K
D1110 Prophylaxis - adult 1,772 1,745 $106K
D2391 Resin-based composite - one surface, posterior, primary or permanent 386 241 $35K
D0274 Bitewings - four radiographic images 1,373 1,348 $30K
D0330 Panoramic radiographic image 423 421 $18K
D0150 Comprehensive oral evaluation - new or established patient 306 303 $16K
D0272 Bitewings - two radiographic images 465 458 $7K
D0140 Limited oral evaluation - problem focused 123 117 $5K
D1351 Sealant - per tooth 107 26 $4K
D0220 Intraoral - periapical first radiographic image 161 155 $2K
D9230 Inhalation of nitrous oxide / analgesia, anxiolysis 13 12 $234.00