Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
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GARDENDALE FAMILY DENTISTRY

NPI: 1497848451 · GARDENDALE, AL 35071 · General Practice Dentistry · NPI assigned 10/02/2006

$2K
Total Medicaid Paid
148
Total Claims
124
Beneficiaries
6
Codes Billed
2018-02
First Month
2018-11
Last Month

Provider Details

Authorized OfficialHAMRIE, ROBERT (ADMINISTRATOR)
NPI Enumeration Date10/02/2006

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 148 $2K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0120 Periodic oral evaluation - established patient 34 32 $486.00
D1110 Prophylaxis - adult 14 14 $476.00
D1208 Topical application of fluoride, excluding varnish 30 27 $375.00
D0220 Intraoral - periapical first radiographic image 29 25 $264.00
D0230 Intraoral - periapical each additional radiographic image 28 13 $130.00
D1206 Topical application of fluoride varnish 13 13 $120.00