Dental Center of ST. George LLC

Dental Center of ST. George LLC was paid $10K by Medicaid between Apr 2021 and Jul 2021, across 3 billing codes. Its largest line is D0140, Limited oral evaluation - problem focused — 97% of everything it billed.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2021	145	$10K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0140	Limited oral evaluation - problem focused	97%	58	57	$9K
D7140	Extraction, erupted tooth or exposed root	2.7%	36	12	$257.04
D0220	Intraoral - periapical first radiographic image	<1%	51	50	$16.78

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.

From NPPES

Who's on the registration

Authorized officialIMLAY, JACKIE (OWNER)