Medicaid Provider Spending

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

NPI: 1427641950 · PEARL, MS 39208 · Dental Clinic/Center · NPI assigned 02/16/2021

$616.72
Total Medicaid Paid
31
Total Claims
24
Beneficiaries
2
Codes Billed
2022-07
First Month
2022-07
Last Month

Provider Details

Authorized OfficialLILES, ANTOINETTE (OWNER/OPERATING DENTIST)
NPI Enumeration Date02/16/2021

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2022 31 $616.72

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1120 Prophylaxis - child 16 12 $346.12
D1206 Topical application of fluoride varnish 15 12 $270.60