Medicaid Provider Spending

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

CENTER GROVE DENTAL, LLC

NPI: 1881152585 · GREENWOOD, IN 46142 · Dentist · NPI assigned 03/12/2019

$157.69
Total Medicaid Paid
12
Total Claims
12
Beneficiaries
1
Codes Billed
2022-10
First Month
2022-10
Last Month

Provider Details

Authorized OfficialKONG, SUNG (OWNER)
NPI Enumeration Date03/12/2019

Related Entities

Other providers sharing the same authorized official: KONG, SUNG

ProviderCityStateTotal Paid
BRIGHT SMILE DENTAL CARE FISHERS IN $14K
WEST 38TH DENTAL, LTD INDIANAPOLIS IN $4K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2022 12 $157.69

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0220 Intraoral - periapical first radiographic image 12 12 $157.69