Medicaid Provider Spending
$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home
›
HI
›
LIHUE
› GARDEN ISLAND DENTAL LLC
GARDEN ISLAND DENTAL LLC
NPI: 1912591173 · LIHUE, HI 96766 ·
Dental Clinic/Center
· NPI assigned 02/26/2021
$3K
Total Medicaid Paid
67
Total Claims
67
Beneficiaries
2
Codes Billed
2023-05
First Month
2024-08
Last Month
Provider Details
Authorized Official
GODLA, CHRISTOPHER
(DENTIST)
NPI Enumeration Date
02/26/2021
Monthly Spending Trend
Yearly Breakdown
Year
Claims
Total Paid
2023
40
$2K
2024
27
$940.00
Billing Codes
Code
Description
Claims
Beneficiaries
Total Paid
D1110
Prophylaxis - adult
28
28
$1K
D0120
Periodic oral evaluation - established patient
39
39
$1K