Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › GA › COLUMBUS › MOON ROAD COSMETIC & FAMILY DENTISTRY

MOON ROAD COSMETIC & FAMILY DENTISTRY

NPI: 1790970614 · COLUMBUS, GA 31909 · Dentist · NPI assigned 09/13/2007

$216.00
Total Medicaid Paid
12
Total Claims
12
Beneficiaries
1
Codes Billed
2018-03
First Month
2018-03
Last Month

Provider Details

Authorized OfficialOBEBE, DAYO (DIRECTOR)
NPI Enumeration Date09/13/2007

Related Entities

Other providers sharing the same authorized official: OBEBE, DAYO

ProviderCityStateTotal Paid
RIVERCHASE DENTAL CARE PHENIX CITY AL $816K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 12 $216.00

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1208 Topical application of fluoride, excluding varnish 12 12 $216.00