J & S SMILE PROS
NPI: 1023729258
· CHICOPEE, MA 01020
· State or Local Public Health Clinic/Center
· NPI assigned 12/08/2022
$244K
Total Medicaid Paid
Provider Details
| Authorized Official | JAMBARD, SARA (PRESIDENT) |
| NPI Enumeration Date | 12/08/2022 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
2,717 |
$100K |
| 2024 |
4,003 |
$144K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1351 |
Sealant - per tooth |
1,569 |
477 |
$67K |
| D1120 |
Prophylaxis - child |
1,268 |
1,264 |
$67K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,797 |
1,791 |
$55K |
| D0190 |
|
1,939 |
1,935 |
$52K |
| D1110 |
Prophylaxis - adult |
87 |
87 |
$3K |
| D9410 |
|
18 |
18 |
$0.00 |
| D1330 |
|
42 |
42 |
$0.00 |