Medicaid Provider Spending

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

TIDEWATER LLC

NPI: 1518470251 · LEXINGTON PARK, MD 20653 · Dentist · NPI assigned 11/15/2017

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official COOPER, DAVID controls 13+ related entities in our dataset. Read more

$192K
Total Medicaid Paid
4,978
Total Claims
4,550
Beneficiary Records
14
Codes Billed
2018-01
First Month
2019-04
Last Month

Provider Details

Authorized OfficialCOOPER, DAVID (OWNER)
NPI Enumeration Date11/15/2017

Related Entities

Other providers sharing the same authorized official: COOPER, DAVID

ProviderCityStateTotal Paid
PROHEALTH CARE ASSOCIATES LLP LAKE SUCCESS NY $69.52M
C H L EMS INC VISALIA CA $10.59M
CHESTER COUNTY PEDIATRICS DOWNINGTON PA $4.85M
STODDARD COUNTY AMBULANCE DISTRICT DEXTER MO $4.67M
TIDEWATER LLC LEXINGTON PARK MD $735K
DRS. COOPER & BANNINGER, LLC. SALINA KS $587K
NO LIMIT LIFE LLC PENNSAUKEN NJ $366K
TIDEWATER LLC SOLOMONS MD $82K
TIDEWATER LLC PRINCE FREDERICK MD $74K
TIDEWATER LLC DUNKIRK MD $21K
TIDEWATER LLC LANHAM MD $21K
MOBILE MEDICAL SERVICES P.C. NEW HYDE PARK NY $3K
CHESTER COUNTY PEDIATRICS PC AVONDALE PA $2K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 4,896 $187K
2019 82 $5K

Billing Codes

CodeDescriptionClaimsBene. RecordsTotal Paid
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 320 169 $38K
D1206 Topical application of fluoride varnish 1,506 1,499 $37K
D1120 Prophylaxis - child 883 879 $37K
D0120 Periodic oral evaluation - established patient 1,189 1,184 $34K
D1110 Prophylaxis - adult 230 230 $13K
D2391 Resin-based composite - one surface, posterior, primary or permanent 133 86 $12K
D1351 Sealant - per tooth 270 57 $9K
D0274 Bitewings - four radiographic images 192 192 $4K
D0330 Panoramic radiographic image 56 56 $2K
D0150 Comprehensive oral evaluation - new or established patient 40 40 $2K
D0272 Bitewings - two radiographic images 103 103 $2K
D0140 Limited oral evaluation - problem focused 14 14 $604.80
D9230 Inhalation of nitrous oxide / analgesia, anxiolysis 30 29 $540.00
D0220 Intraoral - periapical first radiographic image 12 12 $108.00