Medicaid Provider Spending

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

NPI: 1972665057 · LIVINGSTON, NJ 07039 · General Practice Dentistry · NPI assigned 12/14/2006

$20K
Total Medicaid Paid
1,727
Total Claims
1,726
Beneficiaries
8
Codes Billed
2018-01
First Month
2021-11
Last Month

Provider Details

Authorized OfficialMIKHAILOV, ALEXANDER (OWNER)
NPI Enumeration Date12/14/2006

Related Entities

Other providers sharing the same authorized official: MIKHAILOV, ALEXANDER

ProviderCityStateTotal Paid
KINGS PLAZA DENTAL PC BROOKLYN NY $153K
ROOSEVELT FIELD MALL DENTAL PC GARDEN CITY NY $90K
NEW HORIZON DENTAL, P.C BRONX NY $81K
WASHINGTON HEIGHTS DENTAL PRACTICE, P.C NEW YORK NY $73K
NEWPORT CENTRE DENTAL JERSEY CITY NJ $65K
WILLOWBROOK MALL DENTAL, PA WAYNE NJ $9K
MONMOUTH MALL DENTAL, PA EATONTOWN NJ $607.50

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 844 $10K
2019 534 $6K
2020 153 $2K
2021 196 $2K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0120 Periodic oral evaluation - established patient 627 627 $10K
D1110 Prophylaxis - adult 287 287 $5K
D0230 Intraoral - periapical each additional radiographic image 256 256 $2K
D0220 Intraoral - periapical first radiographic image 396 395 $2K
D0210 Intraoral - complete series of radiographic images 41 41 $1K
D0272 Bitewings - two radiographic images 93 93 $517.50
D1120 Prophylaxis - child 14 14 $196.00
D1208 Topical application of fluoride, excluding varnish 13 13 $130.00