Medicaid Provider Spending

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

PEARL SMILE DENTAL PC

NPI: 1417335985 · UNION CITY, NJ 07087 · General Practice Dentistry · NPI assigned 05/15/2015

$900.25
Total Medicaid Paid
511
Total Claims
484
Beneficiaries
6
Codes Billed
2018-07
First Month
2020-02
Last Month

Provider Details

Authorized OfficialKHALID, RASHID (OWNER)
NPI Enumeration Date05/15/2015

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 196 $319.25
2019 290 $551.00
2020 25 $30.00

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1110 Prophylaxis - adult 138 138 $540.50
D0120 Periodic oral evaluation - established patient 79 79 $103.00
D2391 Resin-based composite - one surface, posterior, primary or permanent 36 13 $96.50
D0230 Intraoral - periapical each additional radiographic image 73 72 $81.50
D0220 Intraoral - periapical first radiographic image 129 127 $78.75
D0274 Bitewings - four radiographic images 56 55 $0.00