Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › ID › AMMON › SUNRISE SMILES

SUNRISE SMILES

NPI: 1245978329 · AMMON, ID 83406 · 122300000X

$21K
Total Medicaid Paid
917
Total Claims
848
Beneficiaries
11
Codes Billed
2023-07
First Month
2024-11
Last Month

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2023 637 $15K
2024 280 $6K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1110 162 162 $8K
D2392 77 28 $4K
D0210 32 32 $4K
D0140 51 51 $2K
D0330 59 58 $2K
D2391 30 13 $694.84
D0150 66 65 $485.04
D0274 144 144 $194.67
D0120 148 148 $69.91
D1206 83 83 $0.00
D0220 65 64 $0.00