KIDS TEETH, LLC
NPI: 1053376491
· MOUNT PLEASANT, SC 29466
· Orthodontics and Dentofacial Orthopedic Dentist
· NPI assigned 04/19/2006
$257K
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
959 |
$21K |
| 2019 |
1,445 |
$33K |
| 2020 |
1,330 |
$31K |
| 2021 |
1,978 |
$48K |
| 2022 |
1,986 |
$44K |
| 2023 |
1,822 |
$42K |
| 2024 |
1,721 |
$38K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
3,537 |
3,537 |
$77K |
| D1206 |
Topical application of fluoride varnish |
3,948 |
3,948 |
$62K |
| D1120 |
Prophylaxis - child |
1,804 |
1,804 |
$60K |
| D1110 |
Prophylaxis - adult |
633 |
633 |
$29K |
| D0272 |
Bitewings - two radiographic images |
962 |
962 |
$17K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
312 |
304 |
$9K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
45 |
45 |
$2K |