Medicaid Provider Spending

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

KIATKACHORN RATANATHARATHORN, DDS INC

NPI: 1891402079 · WEST COVINA, CA 91792 · Dental Clinic/Center · NPI assigned 10/27/2022

$9K
Total Medicaid Paid
164
Total Claims
164
Beneficiaries
3
Codes Billed
2023-06
First Month
2024-11
Last Month

Provider Details

Authorized OfficialRATANATHARATHORN, KIATKACHORN (PRESIDENT)
NPI Enumeration Date10/27/2022

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2023 51 $3K
2024 113 $5K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0150 Comprehensive oral evaluation - new or established patient 108 108 $7K
D0210 Intraoral - complete series of radiographic images 15 15 $720.00
D1206 Topical application of fluoride varnish 41 41 $686.00