Medicaid Provider Spending

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

APPLE FAMILY DENTISTRY

NPI: 1629309182 · NORTH WALES, PA 19454 · General Practice Dentistry · NPI assigned 01/22/2010

$27K
Total Medicaid Paid
710
Total Claims
680
Beneficiaries
6
Codes Billed
2024-08
First Month
2024-12
Last Month

Provider Details

Authorized OfficialKIM, TAE SOO (PRESIDENT)
NPI Enumeration Date01/22/2010

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2024 710 $27K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D2393 Resin-based composite - three surfaces, posterior, primary or permanent 66 59 $8K
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 63 57 $6K
D1110 Prophylaxis - adult 174 169 $5K
D0274 Bitewings - four radiographic images 162 157 $4K
D0120 Periodic oral evaluation - established patient 163 160 $3K
D0220 Intraoral - periapical first radiographic image 82 78 $559.44