Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
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FOUNTAIN MODERN DENTISTRY AND ORTHODONTICS, LLP

NPI: 1730434622 · IRVINE, CA 92606 · General Practice Dentistry · NPI assigned 07/17/2012

$837.00
Total Medicaid Paid
25
Total Claims
25
Beneficiaries
2
Codes Billed
2020-06
First Month
2020-06
Last Month

Provider Details

Authorized OfficialRODGERS, CHARLES (DDS/ OWNER)
NPI Enumeration Date07/17/2012

Related Entities

Other providers sharing the same authorized official: RODGERS, CHARLES

ProviderCityStateTotal Paid
NORTH POWERS MODERN DENTISTRY, LLP COLORADO SPRINGS CO $2K
BRIGHTON MODERN DENTISTRY AND ORTHODONTICS, LLP BRIGHTON CO $462.00

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2020 25 $837.00

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1206 Topical application of fluoride varnish 13 13 $429.00
D0120 Periodic oral evaluation - established patient 12 12 $408.00