CLIFTON SPRINGS SANITARIUM COMPANY

NPI: 1093192742 · CLIFTON SPRINGS, NY 14432 · Internal Medicine Physician · NPI assigned 05/01/2015

$61K

Total Medicaid Paid

1,382

Total Claims

1,368

Beneficiaries

Codes Billed

2021-06

First Month

2023-08

Last Month

Provider Details

Authorized Official	SMITH, DONNA (CHIEF OPERATING OFFICER/CNO)
NPI Enumeration Date	05/01/2015

Other providers sharing the same authorized official: SMITH, DONNA

Provider	City	State	Total Paid
GENUINE HOME HEALTH CARE	HAZELWOOD	MO	$6.84M
LITTLE TESOROS THERAPY SERVICES, L.L.P.	AUSTIN	TX	$792K
PAGE COUNTY SCHOOLS	LURAY	VA	$640K
LITTLE TESOROS THERAPY SERVICES, LLP	AUSTIN	TX	$63K
SOLUTIONS FOR BEHAVIORAL HEALTH	EAST ORANGE	NJ	$49K
MCVAY FAMILY CHIROPRACTIC, INC.	ROCKVILLE	IN	$27K

Code	Description	Claims	Beneficiaries	Total Paid
D1110	Prophylaxis - adult	354	354	$23K
D0330	Panoramic radiographic image	293	293	$13K
D0150	Comprehensive oral evaluation - new or established patient	314	313	$10K
D0274	Bitewings - four radiographic images	139	139	$5K
D1120	Prophylaxis - child	53	53	$3K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	25	12	$2K
D1206	Topical application of fluoride varnish	81	81	$2K
D0120	Periodic oral evaluation - established patient	53	53	$2K
D0140	Limited oral evaluation - problem focused	39	39	$673.34
D0270		13	13	$208.04
D0230	Intraoral - periapical each additional radiographic image	18	18	$42.10