Medicaid Provider Spending

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

RIVERWALK SMILE DENTISTRY, LLC

NPI: 1730629627 · ROCK HILL, SC 29730 · General Practice Dentistry · NPI assigned 02/27/2017

$6K
Total Medicaid Paid
220
Total Claims
220
Beneficiaries
4
Codes Billed
2018-06
First Month
2021-04
Last Month

Provider Details

Authorized OfficialSETH, ANJALI (DENTIST)
NPI Enumeration Date02/27/2017

Related Entities

Other providers sharing the same authorized official: SETH, ANJALI

ProviderCityStateTotal Paid
CAROLINA SMILE DENTISTRY, LLC INDIAN LAND SC $2K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 13 $452.40
2019 149 $3K
2020 13 $299.00
2021 45 $1K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1120 Prophylaxis - child 73 73 $3K
D1206 Topical application of fluoride varnish 95 95 $2K
D0120 Periodic oral evaluation - established patient 39 39 $897.00
D0150 Comprehensive oral evaluation - new or established patient 13 13 $526.50