Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › PA › NORTH WALES › MONTGOMERY MALL DENTAL, LLP

MONTGOMERY MALL DENTAL, LLP

NPI: 1770821761 · NORTH WALES, PA 19454 · Dentist · NPI assigned 01/25/2013

$1K
Total Medicaid Paid
56
Total Claims
55
Beneficiaries
3
Codes Billed
2018-08
First Month
2020-12
Last Month

Provider Details

Authorized OfficialSHAAKOVA, VIKTORIYA (OFFICE MANAGER)
NPI Enumeration Date01/25/2013

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 18 $568.65
2020 38 $885.00

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1110 Prophylaxis - adult 31 30 $1K
D0274 Bitewings - four radiographic images 12 12 $325.80
D0220 Intraoral - periapical first radiographic image 13 13 $101.40