Dental
Smile Zone Dentistry, Port Jervis PC
Smile Zone Dentistry, Port Jervis PC was paid $4K by Medicaid between Aug 2020 and Apr 2022, across 6 billing codes. Its largest line is D1110, Prophylaxis - adult — 56% of everything it billed.
33Billing provider infoSMILE ZONE DENTISTRY, PORT JERVIS PC
PORT JERVIS, NY 12771
PORT JERVIS, NY 12771
33aNPI1164861266assigned 06/21/2013
33bProvider typeGeneral Practice Dentistry
28Total paid$4K
24GClaims394
24DCodes billed6
24AFirst – last monthAug 2020 – Apr 2022
Compared with peers
Next to other General Practice Dentistry providers in New York
Rank by total paid#1,751 of 2,184
Median peer was paid$54K
This provider vs. median0.1×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2020 | 90 | $0.00 | |
| 2021 | 249 | $2K | |
| 2022 | 55 | $2K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 56% | 43 | 43 | $2K |
| D0150 | Comprehensive oral evaluation - new or established patient | 15% | 20 | 20 | $600.00 |
| D1120 | Dental cleaning, childProphylaxis - child | 13% | 12 | 12 | $516.00 |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 9.9% | 15 | 15 | $408.90 |
| D0210 | Intraoral - complete series of radiographic images | 7.5% | 13 | 13 | $308.32 |
| D1999 | 0% | 291 | 238 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialBAJAJ, SAMIR (DIRECTOR)
| Provider | Location | Paid |
|---|---|---|
| Smile Zone Dentistry Clintondale PC | Clintondale, NY | $23K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.