Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › IN › INDIANAPOLIS › MY INDY DENTAL CENTER LLC

MY INDY DENTAL CENTER LLC

NPI: 1265101315 · INDIANAPOLIS, IN 46205 · Dental Clinic/Center · NPI assigned 09/11/2021

$14K
Total Medicaid Paid
395
Total Claims
216
Beneficiaries
6
Codes Billed
2023-02
First Month
2023-03
Last Month

Provider Details

Authorized OfficialBARTA, BRENT (MEMBER)
NPI Enumeration Date09/11/2021

Related Entities

Other providers sharing the same authorized official: BARTA, BRENT

ProviderCityStateTotal Paid
WTDG SPECIALIST GROUP LLC INDIANAPOLIS IN $5.98M
WEST 10TH DENTAL GROUP, PROFESSIONAL CORPORATION INDIANAPOLIS IN $3.32M
GEORGETOWN DENTAL CENTER INDIANAPOLIS IN $2.03M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2023 395 $14K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1354 87 15 $8K
D1351 Sealant - per tooth 80 15 $2K
D0240 81 42 $1K
D1120 Prophylaxis - child 43 42 $1K
D1206 Topical application of fluoride varnish 56 55 $1K
D0120 Periodic oral evaluation - established patient 48 47 $858.04