WASHINGTON STATE SMILE PARTNERS
NPI: 1548454655
· BAINBRIDGE ISLAND, WA 98110
· Voluntary or Charitable Agency
· NPI assigned 08/31/2007
$344K
Total Medicaid Paid
Provider Details
| Authorized Official | MILLS, KATHLEEN (PROGRAM DIRECTOR) |
| NPI Enumeration Date | 08/31/2007 |
Related Entities
Other providers sharing the same authorized official: MILLS, KATHLEEN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
29,406 |
$300K |
| 2019 |
4,958 |
$44K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0191 |
|
11,017 |
9,681 |
$103K |
| D1330 |
|
11,014 |
9,681 |
$83K |
| D1206 |
Topical application of fluoride varnish |
6,043 |
5,657 |
$74K |
| D1351 |
Sealant - per tooth |
3,458 |
745 |
$51K |
| D1120 |
Prophylaxis - child |
2,832 |
2,592 |
$33K |