Medicaid Provider Spending

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

DAS, DIPTI

NPI: 1659360444 · HAVERSTRAW, NY 10927 · General Practice Dentistry · NPI assigned 10/14/2005

$12K
Total Medicaid Paid
348
Total Claims
299
Beneficiaries
9
Codes Billed
2018-03
First Month
2018-11
Last Month

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 348 $12K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D2140 60 28 $3K
D0120 Periodic oral evaluation - established patient 113 113 $3K
D2150 Silver amalgam - two surfaces, primary or permanent 38 25 $3K
D2330 16 12 $993.55
D1110 Prophylaxis - adult 15 15 $674.00
D0220 Intraoral - periapical first radiographic image 26 26 $511.30
D0230 Intraoral - periapical each additional radiographic image 32 32 $429.50
D1208 Topical application of fluoride, excluding varnish 32 32 $390.70
D0274 Bitewings - four radiographic images 16 16 $385.40