SPACE CITY PEDIATRIC DENTISTRY
NPI: 1487811659
· FRIENDSWOOD, TX 77546
· 1223P0221X
$4.11M
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
114 |
$2K |
| 2019 |
413 |
$6K |
| 2020 |
3,793 |
$119K |
| 2021 |
35,989 |
$1.16M |
| 2022 |
36,438 |
$1.12M |
| 2023 |
34,674 |
$1.04M |
| 2024 |
23,966 |
$669K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D2930 |
|
4,340 |
1,620 |
$592K |
| D0120 |
|
20,225 |
19,469 |
$550K |
| D1120 |
|
15,452 |
14,836 |
$531K |
| D2392 |
|
3,970 |
2,282 |
$353K |
| D9248 |
|
2,991 |
2,762 |
$323K |
| D1110 |
|
6,087 |
5,859 |
$312K |
| D1206 |
|
20,663 |
19,882 |
$286K |
| D0145 |
|
1,913 |
1,855 |
$257K |
| D0272 |
|
8,055 |
7,705 |
$176K |
| D0274 |
|
3,653 |
3,526 |
$119K |
| D9230 |
|
4,628 |
4,221 |
$112K |
| D2391 |
|
1,206 |
893 |
$86K |
| D1351 |
|
3,057 |
811 |
$74K |
| D0150 |
|
1,832 |
1,699 |
$56K |
| D0220 |
|
5,051 |
4,703 |
$56K |
| D3220 |
|
614 |
381 |
$45K |
| D7140 |
|
1,111 |
591 |
$44K |
| D0330 |
|
701 |
680 |
$40K |
| D0140 |
|
1,806 |
1,703 |
$30K |
| D0210 |
|
462 |
435 |
$29K |
| D0230 |
|
2,591 |
1,878 |
$23K |
| D1208 |
|
442 |
421 |
$6K |
| D7111 |
|
387 |
242 |
$4K |
| D2393 |
|
40 |
28 |
$2K |
| D3120 |
|
13 |
12 |
$57.34 |
| D0603 |
|
11,800 |
11,364 |
$0.00 |
| D0601 |
|
2,167 |
2,081 |
$0.00 |
| D0602 |
|
10,108 |
9,784 |
$0.00 |
| D1999 |
|
22 |
20 |
$0.00 |