Medicaid Provider Spending

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

SB DENTAL LLC

NPI: 1376055574 · LOS LUNAS, NM 87031 · Dental Clinic/Center · NPI assigned 10/27/2017

$117.92
Total Medicaid Paid
12
Total Claims
12
Beneficiaries
1
Codes Billed
2018-09
First Month
2018-09
Last Month

Provider Details

Authorized OfficialYOON, JAJUNG (CEP)
NPI Enumeration Date10/27/2017

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 12 $117.92

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0220 Intraoral - periapical first radiographic image 12 12 $117.92