LITTLE SMILES OF NORTHERN VIRGINIA PLLC
NPI: 1376969386
· FALLS CHURCH, VA 22046
· Dental Clinic/Center
· NPI assigned 03/14/2014
$179K
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
2,092 |
$54K |
| 2019 |
2,232 |
$55K |
| 2020 |
1,714 |
$41K |
| 2021 |
1,186 |
$29K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
2,079 |
2,066 |
$68K |
| D1206 |
Topical application of fluoride varnish |
2,195 |
2,182 |
$44K |
| D0120 |
Periodic oral evaluation - established patient |
1,885 |
1,871 |
$37K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
387 |
359 |
$13K |
| D0272 |
Bitewings - two radiographic images |
443 |
439 |
$9K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
141 |
141 |
$4K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
21 |
12 |
$2K |
| D1351 |
Sealant - per tooth |
24 |
13 |
$774.72 |
| D0240 |
|
49 |
26 |
$601.23 |