Medicaid Provider Spending

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

EAGLE ROCK DENTAL CARE ARCO PLLC

NPI: 1457608671 · ARCO, ID 83213 · Dentist · NPI assigned 08/07/2012

$827.51
Total Medicaid Paid
99
Total Claims
99
Beneficiaries
3
Codes Billed
2018-01
First Month
2020-06
Last Month

Provider Details

Authorized OfficialCHAPPLE, TRUDEE (OFFICE ADMINISTRATOR)
NPI Enumeration Date08/07/2012

Related Entities

Other providers sharing the same authorized official: CHAPPLE, TRUDEE

ProviderCityStateTotal Paid
EAGLE ROCK DENTAL CARE IDAHO FALLS ID $23K
EAGLE ROCK DENTAL CARE OF REXBURG REXBURG ID $14K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 61 $0.00
2019 26 $827.51
2020 12 $0.00

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1120 Prophylaxis - child 12 12 $827.51
D1208 Topical application of fluoride, excluding varnish 36 36 $0.00
D0120 Periodic oral evaluation - established patient 51 51 $0.00