AFFORDABLE SMILES, INC.
NPI: 1336514132
· MEADVILLE, PA 16335
· Dentist
· NPI assigned 12/04/2015
$894.70
Total Medicaid Paid
Provider Details
| Authorized Official | HITCHCOCK, JEREMY (CHIEF OPERATING OFFICER) |
| Parent Organization | AFFORDABLE SMILES, INC |
| NPI Enumeration Date | 12/04/2015 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
42 |
$894.70 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0330 |
Panoramic radiographic image |
15 |
15 |
$402.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
14 |
14 |
$268.30 |
| D0120 |
Periodic oral evaluation - established patient |
13 |
13 |
$224.40 |