Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › NE › COZAD › DAVIS FAMILY DENTAL, LLC

DAVIS FAMILY DENTAL, LLC

NPI: 1437296225 · COZAD, NE 69130 · Dental Clinic/Center · NPI assigned 01/31/2007

$10K
Total Medicaid Paid
445
Total Claims
445
Beneficiaries
4
Codes Billed
2018-01
First Month
2019-03
Last Month

Provider Details

Authorized OfficialDAVIS, TIMOTHY (OWNER)
NPI Enumeration Date01/31/2007

Related Entities

Other providers sharing the same authorized official: DAVIS, TIMOTHY

ProviderCityStateTotal Paid
SAFE@HOME LLC EAU CLAIRE WI $151K
ALPHA DIAGNOSTICS, P.C. SANTA MONICA CA $1K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 322 $7K
2019 123 $3K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0120 Periodic oral evaluation - established patient 197 197 $4K
D1206 Topical application of fluoride varnish 192 192 $4K
D1110 Prophylaxis - adult 27 27 $858.00
D1120 Prophylaxis - child 29 29 $754.00