Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

BRIGHT SMILE DENTAL CLINIC

NPI: 1124219993 · TERRELL, TX 75160 · Dentist · NPI assigned 08/07/2007

$16K
Total Medicaid Paid
947
Total Claims
877
Beneficiaries
8
Codes Billed
2020-11
First Month
2021-07
Last Month

Provider Details

Authorized OfficialKINES, GWENDOLYN (OWNER)
NPI Enumeration Date08/07/2007

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2020 195 $3K
2021 752 $14K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0120 Periodic oral evaluation - established patient 173 167 $5K
D1208 Topical application of fluoride, excluding varnish 189 183 $3K
D1120 Prophylaxis - child 73 71 $3K
D0274 Bitewings - four radiographic images 68 68 $2K
D1110 Prophylaxis - adult 39 39 $2K
D0230 Intraoral - periapical each additional radiographic image 121 72 $1K
D0220 Intraoral - periapical first radiographic image 75 75 $891.16
D0603 209 202 $0.00