Medicaid Provider Spending

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

TIDEWATER LLC

NPI: 1306359054 · PRINCE FREDERICK, MD 20678 · 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

$74K
Total Medicaid Paid
2,529
Total Claims
2,469
Beneficiaries
12
Codes Billed
2018-10
First Month
2024-11
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
TIDEWATER LLC LEXINGTON PARK MD $735K
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 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 53 $2K
2019 514 $15K
2020 353 $8K
2021 290 $9K
2022 574 $16K
2023 239 $7K
2024 506 $18K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1206 Topical application of fluoride varnish 1,069 1,049 $26K
D1120 Prophylaxis - child 413 411 $18K
D0120 Periodic oral evaluation - established patient 584 572 $17K
D1110 Prophylaxis - adult 72 72 $5K
D0274 Bitewings - four radiographic images 110 103 $2K
D0150 Comprehensive oral evaluation - new or established patient 36 35 $2K
D0220 Intraoral - periapical first radiographic image 155 144 $1K
D0210 Intraoral - complete series of radiographic images 16 16 $912.00
D0140 Limited oral evaluation - problem focused 17 17 $803.42
D0330 Panoramic radiographic image 13 13 $546.00
D9230 Inhalation of nitrous oxide / analgesia, anxiolysis 12 12 $216.00
D0230 Intraoral - periapical each additional radiographic image 32 25 $145.28