Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › SC › FORT MILL › CLARK AND JACKSON PD, LLC

CLARK AND JACKSON PD, LLC

NPI: 1811598493 · FORT MILL, SC 29708 · Pediatric Dentist · NPI assigned 11/02/2020

$7K
Total Medicaid Paid
385
Total Claims
385
Beneficiaries
4
Codes Billed
2021-03
First Month
2024-05
Last Month

Provider Details

Authorized OfficialJACKSON, STEPHANIE (OWNER)
NPI Enumeration Date11/02/2020

Related Entities

Other providers sharing the same authorized official: JACKSON, STEPHANIE

ProviderCityStateTotal Paid
AAA CARE LLC NEW ORLEANS LA $14.87M
A BETTER DAY HOME CARE SERVICES, INC. CHARLOTTE NC $2.67M
EVERYCARE EXPRESS CLINIC CANTON MS $1.39M
AAA CARE LLC NEW ORLEANS LA $1.33M
AAA CARE LLC NEW ORLEANS LA $243K
A SUNNY DAY HOME HEALTHCARE INC CHARLOTTE NC $111K
JACKSON PEDIATRIC DENTISTRY LLC ROCK HILL SC $32K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2021 167 $3K
2022 95 $2K
2023 108 $2K
2024 15 $327.20

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0120 Periodic oral evaluation - established patient 223 223 $5K
D1206 Topical application of fluoride varnish 137 137 $2K
D1120 Prophylaxis - child 13 13 $382.80
D0220 Intraoral - periapical first radiographic image 12 12 $153.96