Medicaid Provider Spending

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

HARTSELL, SHUTONG

NPI: 1851813430 · ARLINGTON, VA 22202 · General Practice Dentistry · NPI assigned 07/14/2017

$16K
Total Medicaid Paid
683
Total Claims
610
Beneficiaries
8
Codes Billed
2018-01
First Month
2019-05
Last Month

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 493 $11K
2019 190 $5K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1208 Topical application of fluoride, excluding varnish 269 251 $5K
D1110 Prophylaxis - adult 53 47 $3K
D0120 Periodic oral evaluation - established patient 104 97 $3K
D0150 Comprehensive oral evaluation - new or established patient 32 28 $2K
D0220 Intraoral - periapical first radiographic image 95 87 $1K
D1120 Prophylaxis - child 29 26 $1K
D0274 Bitewings - four radiographic images 30 26 $861.39
D0230 Intraoral - periapical each additional radiographic image 71 48 $667.32