Medicaid Provider Spending

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

NPI: 1508078007 · BOWIE, MD 20720 · General Practice Dentistry · NPI assigned 05/04/2007

$14K
Total Medicaid Paid
494
Total Claims
492
Beneficiaries
5
Codes Billed
2018-01
First Month
2019-01
Last Month

Provider Details

Authorized OfficialHIGHTOWER, CLARINE (OWNER)
NPI Enumeration Date05/04/2007

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 451 $13K
2019 43 $1K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0120 Periodic oral evaluation - established patient 175 174 $5K
D1206 Topical application of fluoride varnish 192 191 $5K
D1120 Prophylaxis - child 72 72 $3K
D1110 Prophylaxis - adult 12 12 $697.80
D1330 43 43 $258.00