Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › NY › HARTSDALE › PRIMARY CARE DENTAL PC

PRIMARY CARE DENTAL PC

NPI: 1669764015 · HARTSDALE, NY 10530 · Dentist · NPI assigned 05/04/2011

$3K
Total Medicaid Paid
136
Total Claims
136
Beneficiaries
4
Codes Billed
2018-01
First Month
2018-10
Last Month

Provider Details

Authorized OfficialKIM, JEFFREY (OWNER)
NPI Enumeration Date05/04/2011

Related Entities

Other providers sharing the same authorized official: KIM, JEFFREY

ProviderCityStateTotal Paid
DR. JEFFREY J KIM'S DENTAL, INC. SAN BERNARDINO CA $1.18M
HAMPTON FAMILY DENTISTRY MIDDLETOWN NY $6K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 136 $3K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0120 Periodic oral evaluation - established patient 63 63 $2K
D1208 Topical application of fluoride, excluding varnish 47 47 $547.40
D1120 Prophylaxis - child 14 14 $398.75
D0274 Bitewings - four radiographic images 12 12 $295.80