SUMMIT SMILES PEDIATRIC DENTISTRY, LLC
NPI: 1629602529
· VESTAVIA, AL 35243
· 1223P0221X
$360K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
1,767 |
$28K |
| 2021 |
3,187 |
$69K |
| 2022 |
4,071 |
$110K |
| 2023 |
3,560 |
$83K |
| 2024 |
3,036 |
$70K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D2930 |
|
801 |
142 |
$70K |
| D1120 |
|
2,683 |
2,551 |
$65K |
| D0120 |
|
2,491 |
2,373 |
$47K |
| D1206 |
|
1,621 |
1,569 |
$38K |
| D1999 |
|
2,243 |
1,977 |
$37K |
| D0272 |
|
1,090 |
1,004 |
$16K |
| D1208 |
|
1,163 |
1,076 |
$15K |
| D0150 |
|
379 |
361 |
$10K |
| D9230 |
|
441 |
401 |
$10K |
| D0140 |
|
314 |
304 |
$9K |
| D0220 |
|
922 |
863 |
$9K |
| D0240 |
|
630 |
290 |
$9K |
| D2392 |
|
109 |
57 |
$9K |
| D0330 |
|
158 |
154 |
$7K |
| D1110 |
|
101 |
100 |
$4K |
| D0230 |
|
400 |
174 |
$3K |
| D7140 |
|
47 |
29 |
$3K |
| D0274 |
|
28 |
28 |
$554.40 |