Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › ID › IDAHO FALLS › EAGLE ROCK DENTAL CARE

EAGLE ROCK DENTAL CARE

NPI: 1356465660 · IDAHO FALLS, ID 83401 · Dentist · NPI assigned 03/19/2007

$23K
Total Medicaid Paid
1,386
Total Claims
1,386
Beneficiaries
4
Codes Billed
2018-01
First Month
2024-10
Last Month

Provider Details

Authorized OfficialCHAPPLE, TRUDEE (ADMINISTRATOR)
NPI Enumeration Date03/19/2007

Related Entities

Other providers sharing the same authorized official: CHAPPLE, TRUDEE

ProviderCityStateTotal Paid
EAGLE ROCK DENTAL CARE OF REXBURG REXBURG ID $14K
EAGLE ROCK DENTAL CARE ARCO PLLC ARCO ID $827.51

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 288 $2K
2019 187 $2K
2020 172 $3K
2021 129 $3K
2022 352 $8K
2023 207 $4K
2024 51 $2K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1110 Prophylaxis - adult 347 347 $23K
D0274 Bitewings - four radiographic images 66 66 $207.42
D0120 Periodic oral evaluation - established patient 777 777 $156.59
D1206 Topical application of fluoride varnish 196 196 $0.00