SMILELINE DENTAL PC
NPI: 1538822663
· HERNDON, VA 20170
· Dental Clinic/Center
· NPI assigned 10/15/2021
$581.20
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
40 |
$581.20 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0230 |
Intraoral - periapical each additional radiographic image |
28 |
12 |
$406.84 |
| D0220 |
Intraoral - periapical first radiographic image |
12 |
12 |
$174.36 |