Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › NY › FAIRPORT › DE LOS SANTOS, ABNER

DE LOS SANTOS, ABNER

NPI: 1710415039 · FAIRPORT, NY 14450 · General Practice Dentistry · NPI assigned 05/31/2017

$2K
Total Medicaid Paid
92
Total Claims
91
Beneficiaries
4
Codes Billed
2020-02
First Month
2020-07
Last Month

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2020 92 $2K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0120 Periodic oral evaluation - established patient 30 30 $826.50
D1120 Prophylaxis - child 15 15 $627.95
D1208 Topical application of fluoride, excluding varnish 15 15 $212.80
D1999 32 31 $0.00