Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › MS › DIBERVILLE › BACK BAY FAMILY DENTISTRY

BACK BAY FAMILY DENTISTRY

NPI: 1316306988 · DIBERVILLE, MS 39540 · General Practice Dentistry · NPI assigned 02/11/2016

$376.44
Total Medicaid Paid
12
Total Claims
12
Beneficiaries
1
Codes Billed
2021-09
First Month
2021-09
Last Month

Provider Details

Authorized OfficialPARKER, JEREMY (OWNER)
NPI Enumeration Date02/11/2016

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2021 12 $376.44

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1120 Prophylaxis - child 12 12 $376.44