Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › NY › WHITE PLAINS › GALLERIA MALL DENTAL PC

GALLERIA MALL DENTAL PC

NPI: 1023155470 · WHITE PLAINS, NY 10601 · General Practice Dentistry · NPI assigned 02/01/2007

$72K
Total Medicaid Paid
9,896
Total Claims
9,821
Beneficiaries
9
Codes Billed
2018-04
First Month
2024-12
Last Month

Provider Details

Authorized OfficialKRASNOV, ROSS (OWNER)
NPI Enumeration Date02/01/2007

Related Entities

Other providers sharing the same authorized official: KRASNOV, ROSS

ProviderCityStateTotal Paid
BRASS MILL MALL DENTAL L.L.P WATERBURY CT $1.26M
TOWN CENTER DENTAL OF STAMFORD P.C. STAMFORD CT $554K
STATEN ISLAND MALL DENTAL, P.C. STATEN ISLAND NY $289K
HUDSON VALLEY PLAZA DENTAL LLP TROY NY $278K
HUDSON VALLEY MALL DENTAL LLP KINGSTON NY $132K
42ND STREET DENTAL, ASSOCIATES NEW YORK NY $112K
ATLANTIC TERMINAL DENTAL, P.C. BROOKLYN NY $81K
PALISADES MALL DENTAL LLP WEST NYACK NY $55K
OAKDALE MALL DENTAL LLP JOHNSON CITY NY $40K
GALLERIA MALL DENTAL PC MIDDLETOWN NY $27K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 181 $571.81
2019 359 $1K
2020 573 $5K
2021 2,411 $19K
2022 2,574 $11K
2023 1,895 $9K
2024 1,903 $27K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1110 Prophylaxis - adult 1,435 1,435 $26K
D0120 Periodic oral evaluation - established patient 1,982 1,979 $17K
D0274 Bitewings - four radiographic images 1,539 1,537 $14K
D0220 Intraoral - periapical first radiographic image 2,755 2,744 $10K
D0230 Intraoral - periapical each additional radiographic image 1,793 1,789 $4K
D0140 Limited oral evaluation - problem focused 168 167 $396.33
D0330 Panoramic radiographic image 13 13 $199.50
D2391 Resin-based composite - one surface, posterior, primary or permanent 163 109 $178.90
D1208 Topical application of fluoride, excluding varnish 48 48 $23.80