Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › CO › COLORADO SPRINGS › BROADMOOR VALLEY DENTAL CARE, PC

BROADMOOR VALLEY DENTAL CARE, PC

NPI: 1902118508 · COLORADO SPRINGS, CO 80906 · Dentist · NPI assigned 07/12/2010

$1K
Total Medicaid Paid
40
Total Claims
40
Beneficiaries
2
Codes Billed
2021-02
First Month
2021-08
Last Month

Provider Details

Authorized OfficialSPAETH, OLIVER (PRESIDENT)
NPI Enumeration Date07/12/2010

Related Entities

Other providers sharing the same authorized official: SPAETH, OLIVER

ProviderCityStateTotal Paid
BROADMOOR VALLEY DENTAL SERVICES, P.C. COLORADO SPRINGS CO $408K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2021 40 $1K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0120 Periodic oral evaluation - established patient 28 28 $667.60
D1110 Prophylaxis - adult 12 12 $547.50