Medicaid Provider Spending

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

NPI: 1801237912 · ANTIOCH, CA 94509 · General Practice Dentistry · NPI assigned 07/17/2013

$2K
Total Medicaid Paid
102
Total Claims
102
Beneficiaries
3
Codes Billed
2018-01
First Month
2018-09
Last Month

Provider Details

Authorized OfficialLEONG, DAVID (OWNER)
NPI Enumeration Date07/17/2013

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 102 $2K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0120 Periodic oral evaluation - established patient 32 32 $1K
D1206 Topical application of fluoride varnish 58 58 $580.00
D1120 Prophylaxis - child 12 12 $360.00