SMITH, J.
NPI: 1043446297
· SALT LAKE CITY, UT 84117
· General Practice Dentistry
· NPI assigned 06/02/2009
$108K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
195 |
$19K |
| 2019 |
323 |
$62K |
| 2020 |
152 |
$28K |
Billing Codes
| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| D9222 |
|
162 |
158 |
$67K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
340 |
328 |
$39K |
| D7240 |
Removal of impacted tooth - completely bony |
88 |
28 |
$2K |
| D0330 |
Panoramic radiographic image |
80 |
74 |
$223.27 |