Smile Shoppe

Smile Shoppe was paid $1K by Medicaid between Jun 2018 and Jun 2018, across 2 billing codes. Its largest line is D1120, dental cleaning, child — 59% of everything it billed.

33Billing provider infoSMILE SHOPPE
BURLINGTON, IA 52601

33aNPI1356518500assigned 05/15/2008

33bProvider typeDentist

28Total paid$1K

24GClaims29

24DCodes billed2

24AFirst – last monthJun 2018 – Jun 2018

Compared with peers

Next to other Dentist providers in Iowa

Rank by total paid#233 of 268

Median peer was paid$26K

This provider vs. median0.0×

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
2018	29	$1K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1120	Dental cleaning, childProphylaxis - child	59%	14	13	$651.33
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	41%	15	14	$456.00

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 officialGROELTZ, AMY (PRESIDENT/DENTIST)