MYSMILE DENTISTRY PLLC
NPI: 1598547861
· CARROLLTON, TX 75007
· General Practice Dentistry
· NPI assigned 10/19/2023
$633.81
Total Medicaid Paid
Provider Details
| Authorized Official | SUGGALA, TARANGINI (SOLE MEMEBER/DENTIST) |
| NPI Enumeration Date | 10/19/2023 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
69 |
$633.81 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0230 |
Intraoral - periapical each additional radiographic image |
24 |
14 |
$264.73 |
| D1208 |
Topical application of fluoride, excluding varnish |
14 |
14 |
$205.80 |
| D0220 |
Intraoral - periapical first radiographic image |
14 |
14 |
$163.28 |
| D0603 |
|
17 |
17 |
$0.00 |