Medicaid Provider Spending

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

REDBANK FAMILY DENTISTRY

NPI: 1780066589 · GOOSE CREEK, SC 29445 · General Practice Dentistry · NPI assigned 06/29/2015

$12K
Total Medicaid Paid
359
Total Claims
359
Beneficiaries
5
Codes Billed
2018-03
First Month
2023-04
Last Month

Provider Details

Authorized OfficialGAUTHIER, SERGE (OWNER)
NPI Enumeration Date06/29/2015

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 96 $3K
2019 79 $3K
2020 78 $3K
2021 68 $2K
2022 12 $604.80
2023 26 $918.40

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1110 Prophylaxis - adult 147 147 $7K
D0120 Periodic oral evaluation - established patient 108 108 $2K
D0274 Bitewings - four radiographic images 79 79 $2K
D0140 Limited oral evaluation - problem focused 12 12 $462.00
D1208 Topical application of fluoride, excluding varnish 13 13 $210.60