Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › NJ › WAYNE › WILLOWBROOK MALL DENTAL, PA

WILLOWBROOK MALL DENTAL, PA

NPI: 1174685713 · WAYNE, NJ 07470 · General Practice Dentistry · NPI assigned 12/13/2006

$9K
Total Medicaid Paid
892
Total Claims
891
Beneficiaries
7
Codes Billed
2018-01
First Month
2019-04
Last Month

Provider Details

Authorized OfficialMIKHAILOV, ALEXANDER (OWNER)
NPI Enumeration Date12/13/2006

Related Entities

Other providers sharing the same authorized official: MIKHAILOV, ALEXANDER

ProviderCityStateTotal Paid
KINGS PLAZA DENTAL PC BROOKLYN NY $153K
ROOSEVELT FIELD MALL DENTAL PC GARDEN CITY NY $90K
NEW HORIZON DENTAL, P.C BRONX NY $81K
WASHINGTON HEIGHTS DENTAL PRACTICE, P.C NEW YORK NY $73K
NEWPORT CENTRE DENTAL JERSEY CITY NJ $65K
LIVINGSTON MALL DENTAL, PA LIVINGSTON NJ $20K
MONMOUTH MALL DENTAL, PA EATONTOWN NJ $607.50

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 751 $8K
2019 141 $1K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0120 Periodic oral evaluation - established patient 346 346 $5K
D1110 Prophylaxis - adult 130 130 $2K
D0220 Intraoral - periapical first radiographic image 239 238 $847.50
D0230 Intraoral - periapical each additional radiographic image 107 107 $442.75
D0272 Bitewings - two radiographic images 44 44 $220.00
D1120 Prophylaxis - child 13 13 $182.00
D1208 Topical application of fluoride, excluding varnish 13 13 $130.00