Medicaid Provider Spending
$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home
› 1285809186
1285809186
NPI: 1285809186
Deactivated NPI
· This NPI was deactivated on 06/26/2025.
$85K
Total Medicaid Paid
2,386
Total Claims
1,449
Beneficiaries
5
Codes Billed
2018-01
First Month
2019-12
Last Month
Monthly Spending Trend
Yearly Breakdown
Year
Claims
Total Paid
2018
1,245
$43K
2019
1,141
$41K
Billing Codes
Code
Description
Claims
Beneficiaries
Total Paid
99212
Office or other outpatient visit for the evaluation and management of an established patient, straightforward
2,068
1,138
$81K
D1206
Topical application of fluoride varnish
107
102
$2K
92551
123
121
$1K
99411
18
18
$266.22
99173
70
70
$143.64