Medicaid Provider Spending

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

MONMOUTH MALL DENTAL, PA

NPI: 1437591567 · EATONTOWN, NJ 07724 · General Practice Dentistry · NPI assigned 07/17/2013

$607.50
Total Medicaid Paid
60
Total Claims
60
Beneficiaries
2
Codes Billed
2018-04
First Month
2018-06
Last Month

Provider Details

Authorized OfficialMIKHAILOV, ALEXANDER (PRESIDENT)
NPI Enumeration Date07/17/2013

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
WILLOWBROOK MALL DENTAL, PA WAYNE NJ $9K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 60 $607.50

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0120 Periodic oral evaluation - established patient 34 34 $510.00
D0220 Intraoral - periapical first radiographic image 26 26 $97.50