Dental
Vivid Smiles
Vivid Smiles was paid $88K by Medicaid between Jun 2021 and Aug 2024, across 14 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 27% of everything it billed.
33Billing provider infoVIVID SMILES
SPRINGFIELD, VA 22151
SPRINGFIELD, VA 22151
33aNPI1477226892assigned 07/30/2021
33bProvider typeGeneral Practice Dentistry
28Total paid$88K
24GClaims3,800
24DCodes billed14
24AFirst – last monthJun 2021 – Aug 2024
Compared with peers
Next to other General Practice Dentistry providers in Virginia
Rank by total paid#202 of 549
Median peer was paid$29K
This provider vs. median3.0×
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 | |
|---|---|---|---|
| 2021 | 683 | $24K | |
| 2022 | 1,099 | $42K | |
| 2023 | 1,242 | $22K | |
| 2024incomplete | 776 | $0.00 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 27% | 387 | 193 | $24K |
| D1110 | Prophylaxis - adult | 16% | 509 | 509 | $14K |
| D0150 | Comprehensive oral evaluation - new or established patient | 12% | 351 | 350 | $11K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 8.6% | 100 | 51 | $8K |
| D0274 | Bitewings - four radiographic images | 8.5% | 365 | 363 | $7K |
| D0220 | Intraoral - periapical first radiographic image | 6.1% | 727 | 697 | $5K |
| D0230 | Intraoral - periapical each additional radiographic image | 5.7% | 592 | 474 | $5K |
| D1208 | Topical application of fluoride, excluding varnish | 5.1% | 193 | 193 | $5K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 4.5% | 421 | 419 | $4K |
| D1120 | Dental cleaning, childProphylaxis - child | 4.0% | 105 | 105 | $3K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 1.7% | 13 | 12 | $1K |
| D9994 | <1% | 12 | 12 | $99.36 |
2 more codes
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 officialVIVONI, JORGE (DENTIST)