Medicaid Provider Spending

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

NPI: 1811972094 · DENVER, CO 80224 · Pediatric Dentist · NPI assigned 12/12/2005

$1K
Total Medicaid Paid
91
Total Claims
77
Beneficiaries
3
Codes Billed
2018-03
First Month
2021-02
Last Month

Provider Details

Authorized OfficialSMITH, BRADLEY (PRESIDENT)
NPI Enumeration Date12/12/2005

Related Entities

Other providers sharing the same authorized official: SMITH, BRADLEY

ProviderCityStateTotal Paid
RUSH MEMORIAL HOSPITAL RUSHVILLE IN $10.69M
SFCDP LLC. FORT COLLINS CO $2.71M
BRADLEY W. SMITH, D.O., PLLC PUEBLO CO $1.19M
PREMIER PEDIATRICS, LLC NEWARK DE $876K
VALUDENTAL WALZEM1 PLLC WINDCREST TX $263K
GREENFIELD TOWNSHIP TRUSTEES CARROLL OH $45K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 27 $643.48
2020 13 $200.97
2021 51 $590.40

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1206 Topical application of fluoride varnish 42 37 $600.60
D0120 Periodic oral evaluation - established patient 33 28 $593.77
D1120 Prophylaxis - child 16 12 $240.48