Medicaid Provider Spending

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

NPI: 1972707651 · LEBANON, NH 03766 · General Practice Dentistry · NPI assigned 06/14/2007

$11K
Total Medicaid Paid
476
Total Claims
394
Beneficiaries
5
Codes Billed
2018-01
First Month
2020-07
Last Month

Provider Details

Authorized OfficialSANTA MARIA, ANGELINA (ADMINISTRATOR)
NPI Enumeration Date06/14/2007

Related Entities

Other providers sharing the same authorized official: SANTA MARIA, ANGELINA

ProviderCityStateTotal Paid
SMILES OF WATERBURY, LLC WATERBURY CT $3.20M
REIDVILLE DENTISTRY & IMPLANTS WATERBURY CT $112K
ORAL CARE DENTAL GROUP II, LLC NEW LONDON CT $57K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 313 $6K
2019 150 $4K
2020 13 $345.95

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1208 Topical application of fluoride, excluding varnish 225 182 $3K
D1110 Prophylaxis - adult 54 46 $2K
D1120 Prophylaxis - child 66 54 $2K
D0120 Periodic oral evaluation - established patient 75 62 $2K
D0274 Bitewings - four radiographic images 56 50 $1K