Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
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ANDREA MATLI SCOVILLE DDS PC

NPI: 1881991032 · WATONGA, OK 73772 · Orthodontics and Dentofacial Orthopedic Dentist · NPI assigned 02/24/2011

$738.29
Total Medicaid Paid
41
Total Claims
41
Beneficiaries
2
Codes Billed
2022-08
First Month
2023-07
Last Month

Provider Details

Authorized OfficialSCOVILLE, ANDREA (OWNER)
NPI Enumeration Date02/24/2011

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2022 28 $503.55
2023 13 $234.74

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0120 Periodic oral evaluation - established patient 26 26 $509.69
D1208 Topical application of fluoride, excluding varnish 15 15 $228.60