SURE SMILE, LLC
NPI: 1669704813
· SCARSDALE, NY 10583
· Dentist
· NPI assigned 02/12/2010
$102K
Total Medicaid Paid
Provider Details
| Authorized Official | KHEIR, AHMED (DR.) |
| NPI Enumeration Date | 02/12/2010 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
149 |
$5K |
| 2019 |
407 |
$11K |
| 2020 |
642 |
$17K |
| 2021 |
988 |
$25K |
| 2022 |
1,117 |
$26K |
| 2023 |
654 |
$18K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,104 |
1,100 |
$48K |
| D0274 |
Bitewings - four radiographic images |
1,257 |
1,254 |
$27K |
| D0120 |
Periodic oral evaluation - established patient |
715 |
712 |
$15K |
| D0140 |
Limited oral evaluation - problem focused |
585 |
477 |
$6K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
132 |
132 |
$3K |
| D0210 |
Intraoral - complete series of radiographic images |
151 |
149 |
$3K |
| D1208 |
Topical application of fluoride, excluding varnish |
13 |
13 |
$141.70 |