Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › WV › CHARLESTON › CAPITOL ENDODONTICS, PLLC

CAPITOL ENDODONTICS, PLLC

NPI: 1518330463 · CHARLESTON, WV 25301 · Endodontist · NPI assigned 11/01/2015

$969.00
Total Medicaid Paid
17
Total Claims
14
Beneficiaries
1
Codes Billed
2018-08
First Month
2018-08
Last Month

Provider Details

Authorized OfficialBOUSTANY, AMANDA (OWNER)
NPI Enumeration Date11/01/2015

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 17 $969.00

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0220 Intraoral - periapical first radiographic image 17 14 $969.00