Medicaid Provider Spending

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

NPI: 1467820068 · TWIN FALLS, ID 83301 · Dental Clinic/Center · NPI assigned 09/14/2015

$6K
Total Medicaid Paid
241
Total Claims
236
Beneficiaries
4
Codes Billed
2018-09
First Month
2021-12
Last Month

Provider Details

Authorized OfficialFUKUOKA, BROOKE (OWNER)
NPI Enumeration Date09/14/2015

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 103 $2K
2019 84 $2K
2021 54 $2K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D9410 131 126 $6K
D1110 Prophylaxis - adult 54 54 $0.00
D0150 Comprehensive oral evaluation - new or established patient 31 31 $0.00
D9310 25 25 $0.00