Medicaid Provider Spending

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

MARIA LUISA CO DDS PROFESSIONAL CORPORATION

NPI: 1780842310 · ARCADIA, CA 91006 · General Practice Dentistry · NPI assigned 05/30/2008

$25K
Total Medicaid Paid
859
Total Claims
748
Beneficiaries
8
Codes Billed
2018-03
First Month
2024-10
Last Month

Provider Details

Authorized OfficialCO, MARIA LUISA (CEO)
NPI Enumeration Date05/30/2008

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 41 $532.40
2020 109 $4K
2021 138 $3K
2022 193 $6K
2023 114 $3K
2024 264 $8K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D9430 448 427 $14K
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 49 24 $3K
D1206 Topical application of fluoride varnish 211 211 $3K
D0120 Periodic oral evaluation - established patient 25 25 $2K
D2393 Resin-based composite - three surfaces, posterior, primary or permanent 18 12 $1K
D0350 43 12 $345.60
D1120 Prophylaxis - child 12 12 $330.00
D0230 Intraoral - periapical each additional radiographic image 53 25 $214.35