Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
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KID SMILES PEDIATRIC DENTISTRY OF PORT JEFFERSON STATION PLLC

NPI: 1144921602 · PORT JEFFERSON STATION, NY 11776 · Pediatric Dentist · NPI assigned 03/13/2023

$10K
Total Medicaid Paid
292
Total Claims
292
Beneficiaries
5
Codes Billed
2023-10
First Month
2024-12
Last Month

Provider Details

Authorized OfficialPASTORE, CYNTHIA (INSURANCE COORDINATOR)
NPI Enumeration Date03/13/2023

Related Entities

Other providers sharing the same authorized official: PASTORE, CYNTHIA

ProviderCityStateTotal Paid
KIDDSMILES PEDIATRIC DENTISTRY 7 PLLC FLORAL PARK NY $2.46M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2023 13 $617.76
2024 279 $9K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1120 Prophylaxis - child 101 101 $5K
D0120 Periodic oral evaluation - established patient 84 84 $3K
D0272 Bitewings - two radiographic images 47 47 $883.13
D1208 Topical application of fluoride, excluding varnish 45 45 $696.15
D1206 Topical application of fluoride varnish 15 15 $497.25