Clinic
Special Care Smiles, LLC
Special Care Smiles, LLC was paid $537K by Medicaid between Aug 2021 and Dec 2024, across 24 billing codes. Its largest line is D9920, — 30% of everything it billed.
33Billing provider infoSPECIAL CARE SMILES, LLC
WILKES BARRE, PA 18702
WILKES BARRE, PA 18702
33aNPI1306434584assigned 01/04/2021
33bProvider typeDental Clinic/Center
28Total paid$537K
24GClaims17,212
24DCodes billed24
24AFirst – last monthAug 2021 – Dec 2024
Compared with peers
Next to other Dental Clinic/Center providers in Pennsylvania
Rank by total paid#14 of 78
Median peer was paid$70K
This provider vs. median7.7×
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 | |
|---|---|---|---|
| 2021 | 85 | $8K | |
| 2024incomplete | 17,127 | $529K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D9920 | 30% | 1,301 | 1,228 | $159K | |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 10% | 933 | 478 | $55K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 8.0% | 2,397 | 2,386 | $43K |
| D1120 | Dental cleaning, childProphylaxis - child | 7.8% | 1,518 | 1,514 | $42K |
| D7140 | Extraction, erupted tooth or exposed root | 6.6% | 528 | 239 | $36K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 6.5% | 706 | 433 | $35K |
| D1110 | Prophylaxis - adult | 6.1% | 1,046 | 1,038 | $33K |
| D1206 | Topical application of fluoride varnish | 5.8% | 1,864 | 1,854 | $31K |
| D1351 | Sealant - per tooth | 4.6% | 977 | 262 | $24K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 2.8% | 245 | 172 | $15K |
| D0274 | Bitewings - four radiographic images | 2.2% | 461 | 458 | $12K |
| D1310 | 1.6% | 1,730 | 1,720 | $9K |
12 more codes
| D1330 | 1.6% | 1,730 | $9K | |
| D0272 | Bitewings - two radiographic images | 1.5% | 522 | $8K |
| D0330 | Panoramic radiographic image | 1.0% | 168 | $5K |
| D2332 | <1% | 69 | $4K | |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | <1% | 97 | $4K |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 198 | $4K |
| D0140 | Limited oral evaluation - problem focused | <1% | 61 | $3K |
| D0220 | Intraoral - periapical first radiographic image | <1% | 363 | $3K |
| D0601 | <1% | 184 | $2K | |
| D2330 | <1% | 19 | $1K | |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 56 | $720.93 |
| D0603 | <1% | 39 | $370.00 |
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 officialHOLENA, LAURA (DENTIST)