Medicaid Provider Spending

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

RESTON SUNRISE DENTISTRY, PC

NPI: 1972790376 · RESTON, VA 20191 · Dentist · NPI assigned 09/29/2007

$5K
Total Medicaid Paid
192
Total Claims
180
Beneficiaries
4
Codes Billed
2018-01
First Month
2022-06
Last Month

Provider Details

Authorized OfficialPHAM, HANAH (PRESIDENT)
NPI Enumeration Date09/29/2007

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 103 $3K
2019 37 $761.55
2020 27 $553.01
2022 25 $389.25

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1208 Topical application of fluoride, excluding varnish 84 84 $2K
D9230 Inhalation of nitrous oxide / analgesia, anxiolysis 45 33 $2K
D0120 Periodic oral evaluation - established patient 50 50 $947.05
D1120 Prophylaxis - child 13 13 $435.76