Medicaid Provider Spending

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

WISDOM TEETH ONLY

NPI: 1528518909 · PROVO, UT 84604 · Dentist · NPI assigned 10/10/2016

$6K
Total Medicaid Paid
63
Total Claims
51
Beneficiaries
1
Codes Billed
2020-08
First Month
2022-06
Last Month

Provider Details

Authorized OfficialGARCIA, ELIZABETH (OFFICE MANAGER)
NPI Enumeration Date10/10/2016

Related Entities

Other providers sharing the same authorized official: GARCIA, ELIZABETH

ProviderCityStateTotal Paid
A ROYAL BEHAVIORAL AGENCY LLC LAS VEGAS NV $3.14M
BLOOMING MIND BEHAVIORAL SERVICES LLC COLTON CA $380K
ELIZABETH GARCIA, DDS PROF. DENTAL CORP. SOUTH GATE CA $25K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2020 26 $3K
2021 20 $1K
2022 17 $2K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
00170 Anesthesia for intraoral procedures, including biopsy 63 51 $6K