Medicaid Provider Spending

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

WHITE PLAINS DENTAL CARE, PLLC

NPI: 1629410253 · WHITE PLAINS, NY 10601 · General Practice Dentistry · NPI assigned 07/24/2013

$96K
Total Medicaid Paid
3,848
Total Claims
3,840
Beneficiaries
8
Codes Billed
2018-01
First Month
2020-09
Last Month

Provider Details

Authorized OfficialSHAMUELOV, ROMAN (PRESIDENT)
NPI Enumeration Date07/24/2013

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 1,150 $34K
2019 1,655 $40K
2020 1,043 $22K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1110 Prophylaxis - adult 901 899 $43K
D0120 Periodic oral evaluation - established patient 733 732 $18K
D0274 Bitewings - four radiographic images 640 640 $16K
D0220 Intraoral - periapical first radiographic image 703 702 $8K
D0230 Intraoral - periapical each additional radiographic image 639 637 $7K
D0150 Comprehensive oral evaluation - new or established patient 125 125 $3K
D0210 Intraoral - complete series of radiographic images 31 31 $1K
D1999 76 74 $0.00