Medicaid Provider Spending

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

VIRGINIA PEDIATRIC DENTISTRY PC

NPI: 1912382243 · KESWICK, VA 22947 · Dental Clinic/Center · NPI assigned 07/28/2015

$67K
Total Medicaid Paid
788
Total Claims
302
Beneficiaries
10
Codes Billed
2018-01
First Month
2019-09
Last Month

Provider Details

Authorized OfficialCARNEY, JACQUELINE (PRESIDENT)
NPI Enumeration Date07/28/2015

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 651 $58K
2019 137 $8K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D2930 Prefabricated stainless steel crown - primary tooth 314 51 $42K
D7140 Extraction, erupted tooth or exposed root 158 26 $11K
D9223 Deep sedation/general anesthesia - each subsequent 15 minute increment 66 13 $4K
D9310 32 32 $3K
D2391 Resin-based composite - one surface, posterior, primary or permanent 35 13 $2K
D9630 98 98 $2K
D9222 13 13 $832.00
D9612 13 13 $516.62
D0240 32 16 $392.64
D0220 Intraoral - periapical first radiographic image 27 27 $257.14