Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › VA › CHANTILLY › JASON FARR FAVAGEHI DDS III PC

JASON FARR FAVAGEHI DDS III PC

NPI: 1780736355 · CHANTILLY, VA 20151 · Dentist · NPI assigned 01/17/2007

$34K
Total Medicaid Paid
1,401
Total Claims
1,349
Beneficiaries
7
Codes Billed
2018-01
First Month
2019-04
Last Month

Provider Details

Authorized OfficialFAVAGEHI, JASON (PRESIDENT)
NPI Enumeration Date01/17/2007

Related Entities

Other providers sharing the same authorized official: FAVAGEHI, JASON

ProviderCityStateTotal Paid
CRYSTAL CITY DENTAL ARTS CENTER ARLINGTON VA $13K
JASON FARR FAVAGEHI DDC PC VIENNA VA $12K
JASON F FAVAGEHI DDS PC ARLINGTON VA $3K
CRYSTAL SMILE, PLLC ARLINGTON VA $1K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 988 $24K
2019 413 $10K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1120 Prophylaxis - child 287 287 $10K
D1206 Topical application of fluoride varnish 419 418 $9K
D0120 Periodic oral evaluation - established patient 413 406 $8K
D1110 Prophylaxis - adult 56 51 $2K
D0272 Bitewings - two radiographic images 120 119 $2K
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 22 12 $2K
D0220 Intraoral - periapical first radiographic image 84 56 $637.26