Medicaid Provider Spending

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

PURCELLVILLE PEDIATRIC DENTISTRY

NPI: 1760828297 · PURCELLVILLE, VA 20132 · Pediatric Dentist · NPI assigned 05/10/2013

$92K
Total Medicaid Paid
3,626
Total Claims
3,615
Beneficiaries
5
Codes Billed
2018-01
First Month
2023-03
Last Month

Provider Details

Authorized OfficialMONAJEMY, NOOSHIN (OWNER)
NPI Enumeration Date05/10/2013

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 571 $14K
2019 523 $12K
2020 485 $12K
2021 827 $20K
2022 978 $26K
2023 242 $8K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1120 Prophylaxis - child 1,095 1,093 $38K
D1206 Topical application of fluoride varnish 1,312 1,308 $28K
D0120 Periodic oral evaluation - established patient 1,097 1,092 $23K
D0272 Bitewings - two radiographic images 109 109 $2K
D0150 Comprehensive oral evaluation - new or established patient 13 13 $407.03