Medicaid Provider Spending

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

AVON VILLAGE FAMILY DENTISTRY

NPI: 1376663609 · AVON, CT 06001 · Customized Equipment (DME) · NPI assigned 03/30/2007

$45K
Total Medicaid Paid
1,994
Total Claims
1,872
Beneficiaries
4
Codes Billed
2018-02
First Month
2024-12
Last Month

Provider Details

Authorized OfficialMENTASTI, LAUREN (OWNER)
NPI Enumeration Date03/30/2007

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 99 $2K
2019 131 $3K
2020 88 $2K
2021 315 $6K
2022 335 $8K
2023 477 $12K
2024 549 $12K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0120 Periodic oral evaluation - established patient 1,142 1,080 $23K
D1110 Prophylaxis - adult 733 680 $18K
D1120 Prophylaxis - child 78 75 $3K
D1206 Topical application of fluoride varnish 41 37 $919.22