Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
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AFFORDABLE SMILES OF MANDEVILLE, LLC

NPI: 1407514649 · MANDEVILLE, LA 70448 · General Practice Dentistry · NPI assigned 12/06/2021

$17K
Total Medicaid Paid
445
Total Claims
407
Beneficiaries
7
Codes Billed
2022-06
First Month
2024-07
Last Month

Provider Details

Authorized OfficialCOATS, SAMANTHA (INSURANCE CREDENTIALING MANAGER)
NPI Enumeration Date12/06/2021

Related Entities

Other providers sharing the same authorized official: COATS, SAMANTHA

ProviderCityStateTotal Paid
AFFORDABLE SMILES OF HAMMOND, LLC HAMMOND LA $213K
AFFORDABLE SMILES OF GRETNA, LLC GRETNA LA $208K
AFFORDABLE SMILES OF BATON ROUGE, LLC BATON ROUGE LA $191K
AFFORDABLE SMILES OF METAIRIE, LLC METAIRIE LA $131K
EXCEPTIONAL DENTAL OF WATSON, LLC DENHAM SPRINGS LA $81K
EXCEPTIONAL DENTAL OF UPTOWN, LLC NEW ORLEANS LA $18K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2022 222 $9K
2023 135 $5K
2024 88 $3K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0150 Comprehensive oral evaluation - new or established patient 166 150 $7K
D1110 Prophylaxis - adult 101 93 $5K
D0210 Intraoral - complete series of radiographic images 47 47 $3K
D0120 Periodic oral evaluation - established patient 72 64 $2K
D1208 Topical application of fluoride, excluding varnish 29 27 $670.80
D0272 Bitewings - two radiographic images 16 14 $266.10
D0220 Intraoral - periapical first radiographic image 14 12 $84.45