Medicaid Provider Spending

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

PLEASANT VALLEY DENTAL

NPI: 1790921989 · EL DORADO, CA 95623 · Dentist · NPI assigned 12/18/2008

$90K
Total Medicaid Paid
1,852
Total Claims
875
Beneficiaries
8
Codes Billed
2018-01
First Month
2018-06
Last Month

Provider Details

Authorized OfficialGOODIS, MITCHELL (DENTIST)
NPI Enumeration Date12/18/2008

Related Entities

Other providers sharing the same authorized official: GOODIS, MITCHELL

ProviderCityStateTotal Paid
DIAMOND SPRINGS DENTAL DIAMOND SPRINGS CA $511K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 1,852 $90K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D7210 Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth 544 145 $63K
D7140 Extraction, erupted tooth or exposed root 326 68 $18K
D0230 Intraoral - periapical each additional radiographic image 516 201 $3K
D0220 Intraoral - periapical first radiographic image 262 261 $3K
D9230 Inhalation of nitrous oxide / analgesia, anxiolysis 77 74 $2K
D0150 Comprehensive oral evaluation - new or established patient 26 26 $910.00
D9430 29 29 $812.00
D9610 72 71 $21.00