Medicaid Provider Spending

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

PEMBROKE LAKES MALL DENTAL PA

NPI: 1144945882 · PEMBROKE PINES, FL 33026 · General Practice Dentistry · NPI assigned 10/05/2022

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official KRASNOV, ROSTISLAV controls 17+ related entities in our dataset. Read more

$62K
Total Medicaid Paid
7,118
Total Claims
6,752
Beneficiaries
14
Codes Billed
2022-12
First Month
2024-12
Last Month

Provider Details

Authorized OfficialKRASNOV, ROSTISLAV (OWNER)
NPI Enumeration Date10/05/2022

Related Entities

Other providers sharing the same authorized official: KRASNOV, ROSTISLAV

ProviderCityStateTotal Paid
WESTLAND MALL DENTAL, PA HIALEAH FL $923K
CROSS COUNTY MALL DENTAL, PA WEST PALM BEACH FL $906K
BROWARD MALL DENTAL, PA PLANTATION FL $620K
MIAMI INTERNATIONAL MALL DENTAL, PA MIAMI FL $528K
ALTAMONTE MALL DENTAL PA ALTAMONTE SPRINGS FL $395K
BRANDON MALL DENTAL P.A. BRANDON FL $283K
EDISON MALL DENTAL P.A FORT MYERS FL $255K
BOYNTON BEACH MALL DENTAL PA BOYNTON BEACH FL $174K
SAWGRASS MILLS MALL DENTAL, PA SUNRISE FL $169K
REGENCY SQUARE MALL DENTAL JACKSONVILLE FL $163K
COUNTRYSIDE MALL DENTAL PA CLEARWATER FL $155K
LAUDERHILL MALL DENTAL, PA LAUDERHILL FL $31K
TYRONE SQUARE MALL DENTAL P.A ST PETERSBURG FL $14K
WILLOWBROOK MALL DENTAL HOUSTON TX $10K
METROTECH DENTAL ASSOCIATES PLLC BROOKLYN NY $8K
WHEATON MALL DENTAL LLP WHEATON MD $3K
PG PLAZE DENTAL HYATTSVILLE MD $3K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2022 214 $2K
2023 3,763 $42K
2024 3,141 $19K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0150 Comprehensive oral evaluation - new or established patient 1,301 1,246 $38K
D0210 Intraoral - complete series of radiographic images 124 124 $8K
D0330 Panoramic radiographic image 1,183 1,127 $7K
D0272 Bitewings - two radiographic images 1,233 1,184 $2K
D0220 Intraoral - periapical first radiographic image 1,331 1,253 $2K
D0140 Limited oral evaluation - problem focused 135 124 $1K
D0230 Intraoral - periapical each additional radiographic image 1,249 1,162 $1K
D7210 Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth 21 12 $912.25
D9310 33 31 $533.71
D1208 Topical application of fluoride, excluding varnish 112 108 $497.93
D1110 Prophylaxis - adult 95 91 $394.04
D1330 276 265 $324.42
D4355 13 13 $156.69
D0120 Periodic oral evaluation - established patient 12 12 $60.07