Medicaid Provider Spending

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

PRISTINE SMILE DENTAL PLLC

NPI: 1316692106 · MANCHESTER, CT 06040 · 1223G0001X

$16K

Total Medicaid Paid

454

Total Claims

419

Beneficiaries

7

Codes Billed

2023-10

First Month

2024-12

Last Month

Monthly Spending Trend

Yearly Breakdown

Year	Claims	Total Paid
2023	135	$4K
2024	319	$12K

Billing Codes

Code	Description	Claims	Beneficiaries	Total Paid
D1120		188	177	$8K
D0120		97	87	$3K
D0150		45	42	$2K
D1206		49	48	$1K
D0274		25	24	$876.96
D1208		37	29	$738.92
D1110		13	12	$166.40