Medicaid Provider Spending

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

1639173503

NPI: 1639173503

Deactivated NPI · This NPI was deactivated on 07/20/2020.
$64K
Total Medicaid Paid
2,627
Total Claims
2,337
Beneficiaries
10
Codes Billed
2018-01
First Month
2020-02
Last Month

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 1,239 $9K
2019 1,157 $42K
2020 231 $13K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D4212 51 43 $14K
D1110 Prophylaxis - adult 396 379 $11K
D9920 468 353 $10K
D9230 Inhalation of nitrous oxide / analgesia, anxiolysis 493 403 $8K
D0120 Periodic oral evaluation - established patient 364 349 $5K
D0140 Limited oral evaluation - problem focused 207 199 $4K
D1208 Topical application of fluoride, excluding varnish 308 290 $4K
D2931 28 25 $4K
D0220 Intraoral - periapical first radiographic image 300 284 $2K
D3330 Endodontic therapy, molar tooth (excluding final restoration) 12 12 $2K