Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › NY › FLUSHING › DIVINE DENTAL PC

DIVINE DENTAL PC

NPI: 1235454208 · FLUSHING, NY 11355 · General Practice Dentistry · NPI assigned 04/02/2010

$8K
Total Medicaid Paid
477
Total Claims
468
Beneficiaries
5
Codes Billed
2018-03
First Month
2024-09
Last Month

Provider Details

Authorized OfficialLEE, KEVIN (DENTIST/OWNER)
NPI Enumeration Date04/02/2010

Related Entities

Other providers sharing the same authorized official: LEE, KEVIN

ProviderCityStateTotal Paid
KEVIN S. LEE, M.D. & STEPHEN S. LEE, M.D.,PC FLUSHING NY $80K
JOURNEYPURE MURFREESBORO LLC MURFREESBORO TN $64K
KEVIN T. LEE, M.D., A PROFESSIONAL CORPORATION TEMPLE CITY CA $52K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 12 $60.00
2019 171 $3K
2020 136 $2K
2021 25 $216.96
2023 51 $721.98
2024 82 $1K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1110 Prophylaxis - adult 75 75 $3K
D0220 Intraoral - periapical first radiographic image 206 199 $2K
D0120 Periodic oral evaluation - established patient 66 66 $2K
D0274 Bitewings - four radiographic images 38 38 $816.98
D0230 Intraoral - periapical each additional radiographic image 92 90 $630.04