Medicaid Provider Spending

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

NPI: 1104360718 · SANDY, OR 97055 · General Practice Dentistry · NPI assigned 12/16/2016

$3K
Total Medicaid Paid
206
Total Claims
199
Beneficiaries
4
Codes Billed
2018-04
First Month
2021-05
Last Month

Provider Details

Authorized OfficialLE, TIN (OWNER)
NPI Enumeration Date12/16/2016

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 27 $599.00
2019 26 $575.00
2020 90 $2K
2021 63 $611.00

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0120 Periodic oral evaluation - established patient 71 71 $2K
D1206 Topical application of fluoride varnish 51 51 $871.00
D1120 Prophylaxis - child 12 12 $468.00
D1999 72 65 $105.00