SWEET SMILES DENTAL HYGIENE LLC
NPI: 1063885036
· ELLSWORTH, ME 04605
· Health Maintenance Organization
· NPI assigned 11/12/2015
$240K
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
156 |
$1K |
| 2021 |
245 |
$3K |
| 2022 |
930 |
$19K |
| 2023 |
2,962 |
$96K |
| 2024 |
3,772 |
$120K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
789 |
770 |
$37K |
| D0190 |
|
1,585 |
1,538 |
$33K |
| D1206 |
Topical application of fluoride varnish |
1,367 |
1,332 |
$31K |
| D1354 |
|
918 |
91 |
$25K |
| D4341 |
|
144 |
37 |
$23K |
| D1310 |
|
996 |
968 |
$22K |
| D0274 |
Bitewings - four radiographic images |
250 |
246 |
$11K |
| D1110 |
Prophylaxis - adult |
155 |
152 |
$11K |
| D4910 |
|
83 |
82 |
$9K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
123 |
119 |
$8K |
| D0230 |
Intraoral - periapical each additional radiographic image |
475 |
223 |
$7K |
| D1320 |
|
328 |
256 |
$7K |
| D0220 |
Intraoral - periapical first radiographic image |
273 |
255 |
$6K |
| D0210 |
Intraoral - complete series of radiographic images |
55 |
50 |
$5K |
| D0191 |
|
415 |
374 |
$4K |
| D1330 |
|
96 |
93 |
$2K |
| D4355 |
|
13 |
12 |
$1K |