Medicaid Provider Spending

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

NPI: 1609366756 · LANHAM, MD 20706 · Dentist · NPI assigned 05/15/2018

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

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

$21K
Total Medicaid Paid
689
Total Claims
666
Beneficiaries
6
Codes Billed
2019-03
First Month
2024-03
Last Month

Provider Details

Authorized OfficialCOOPER, DAVID (OWNER)
Parent OrganizationTIDEWATER LLC
NPI Enumeration Date05/15/2018

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 LEXINGTON PARK MD $192K
TIDEWATER LLC SOLOMONS MD $82K
TIDEWATER LLC PRINCE FREDERICK MD $74K
TIDEWATER LLC DUNKIRK 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
2019 121 $4K
2020 90 $2K
2021 49 $1K
2022 148 $4K
2023 269 $9K
2024 12 $586.80

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1120 Prophylaxis - child 212 206 $10K
D1206 Topical application of fluoride varnish 360 346 $9K
D0150 Comprehensive oral evaluation - new or established patient 25 25 $1K
D0120 Periodic oral evaluation - established patient 27 25 $730.68
D0220 Intraoral - periapical first radiographic image 52 51 $531.90
D0230 Intraoral - periapical each additional radiographic image 13 13 $85.28