KOOL SMILES IN-3, PC

NPI: 1447559166 · ELKHART, IN 46517 · Endodontist · NPI assigned 03/21/2011

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

Authorized official VIETH, DAVID controls 20+ related entities in our dataset. Read more

$3.26M

Total Medicaid Paid

114,932

Total Claims

87,415

Beneficiaries

Codes Billed

2018-01

First Month

2024-12

Last Month

Provider Details

Authorized Official	VIETH, DAVID (PRESIDENT)
NPI Enumeration Date	03/21/2011

Related Entities

Other providers sharing the same authorized official: VIETH, DAVID

Provider	City	State	Total Paid
DR. DAVID M. VIETH 2, P.C.	HAGERSTOWN	MD	$77.65M
DR DAVID M VIETH PC	TAKOMA PARK	MD	$45.71M
DR. DAVID M. VIETH 2, PC	BROOKLYN	MD	$35.07M
KOOL SMILES SC-2, PC	CHARLESTON	SC	$28.46M
DAVID M VIETH, DDS, A PROFESSIONAL CORPORATION	LAFAYETTE	LA	$22.57M
DAVID M. VIETH, DDS, A PROFESSIONAL CORPORATION	NEW ORLEANS	LA	$12.46M
DAVID M. VIETH DDS, A PROFESSIONAL CORPORATION	METAIRIE	LA	$11.51M
DAVID M VIETH DDS, A PROFESSIONAL CORPORATION	BATON ROUGE	LA	$10.61M
EAST 53RD STREET DENTAL-2, P.C.	INDIANAPOLIS	IN	$8.94M
DR. DAVID M. VIETH DDS, A PROFESSIONAL CORPORATION	GRETNA	LA	$7.23M
DAVID M VIETH DDS - A PROFESSIONAL CORPORATION	MONROE	LA	$7.21M
DAVID M VIETH DDS, A PROFESSIONAL CORPORATION	LAKE CHARLES	LA	$5.56M
KOOL SMILES IN-3, PC	LAFAYETTE	IN	$5.15M
DAVID M. VIETH DDS, A PROFESSIONAL CORPORATION	SHREVEPORT	LA	$4.92M
KOOL SMILES SC-2, PC	COLUMBIA	SC	$4.22M
KOOL SMILES SC-2, PC	ORANGEBURG	SC	$3.00M
KOOL SMILES SC-2, PC	GREENVILLE	SC	$2.63M
KOOL SMILES SC-2, PC	ROCK HILL	SC	$2.02M
DR. DAVID M. VIETH 2, PC	SALISBURY	MD	$1.17M
KOOL SMILES SC-2, PC	ANDERSON	SC	$773K

Monthly Spending Trend

Yearly Breakdown

Year	Claims	Total Paid
2018	9,820	$49K
2019	11,639	$366K
2020	8,313	$245K
2021	15,079	$444K
2022	23,576	$622K
2023	19,065	$605K
2024	27,440	$926K

Billing Codes

Code	Description	Claims	Beneficiaries	Total Paid
D1351	Sealant - per tooth	17,895	2,990	$465K
D1120	Prophylaxis - child	9,963	9,100	$306K
D1206	Topical application of fluoride varnish	13,338	12,146	$268K
D0120	Periodic oral evaluation - established patient	11,102	10,147	$235K
D1110	Prophylaxis - adult	5,046	4,587	$228K
D2150	Silver amalgam - two surfaces, primary or permanent	2,466	1,442	$180K
D2930	Prefabricated stainless steel crown - primary tooth	1,337	728	$156K
D0150	Comprehensive oral evaluation - new or established patient	4,813	4,416	$155K
D0210	Intraoral - complete series of radiographic images	3,435	3,116	$152K
D7140	Extraction, erupted tooth or exposed root	1,874	1,045	$148K
D2140		2,790	1,630	$147K
D0272	Bitewings - two radiographic images	7,340	6,741	$138K
D0274	Bitewings - four radiographic images	4,874	4,336	$117K
D0220	Intraoral - periapical first radiographic image	8,360	7,729	$90K
D9230	Inhalation of nitrous oxide / analgesia, anxiolysis	3,333	2,794	$83K
D4346		444	429	$81K
D0140	Limited oral evaluation - problem focused	2,172	1,966	$72K
D0230	Intraoral - periapical each additional radiographic image	7,659	6,514	$69K
D0330	Panoramic radiographic image	2,990	2,618	$60K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	503	311	$33K
D2391	Resin-based composite - one surface, posterior, primary or permanent	422	277	$23K
D7240	Removal of impacted tooth - completely bony	43	12	$14K
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth	79	36	$11K
D1208	Topical application of fluoride, excluding varnish	966	916	$7K
D2393	Resin-based composite - three surfaces, posterior, primary or permanent	78	66	$7K
D3220	Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction	56	37	$5K
D2160		30	25	$3K
D2332		19	12	$2K
D7111		40	12	$2K
D9920		44	36	$1K
D1999		1,421	1,201	$780.00