All Medicaid billing entities listing WIETH, CASSANDRA (PAYOR RELATIONS MANAGER) as their authorized official in the NPPES registry.
| State | Entities | Total Paid |
|---|---|---|
| Idaho | 2 | $1.16M |
| Arizona | 1 | $969K |
| Washington | 1 | $171K |
| # | Provider | Location | Specialty | Total Paid |
|---|---|---|---|---|
| 1 | JMJ PRACTICE HOLDINGS, LLC | NAMPA, ID | Pediatric Dentist | $1.09M |
| 2 | SDCAZ LLC | PHOENIX, AZ | Pediatric Dentist | $969K |
| 3 | NICHOLAS RAKLIOS, DDS, PLLC | RENTON, WA | Orthodontics and Dentofacial Orthopedic Dentist | $171K |
| 4 | JMJ PRACTICE HOLDINGS, LLC | NAMPA, ID | Orthodontics and Dentofacial Orthopedic Dentist | $73K |