HEALTHY SMILE DENTAL, PA
NPI: 1689949000
· KATY, TX 77449
· General Practice Dentistry
· NPI assigned 03/19/2012
$227K
Total Medicaid Paid
Provider Details
| Authorized Official | PHAN, THANHHANG (PRESIDENT OF HEALTHY SMILE DENTAL) |
| NPI Enumeration Date | 03/19/2012 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
461 |
$9K |
| 2021 |
3,276 |
$68K |
| 2022 |
3,482 |
$73K |
| 2023 |
2,820 |
$56K |
| 2024 |
1,097 |
$21K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
1,533 |
1,529 |
$44K |
| D1120 |
Prophylaxis - child |
971 |
968 |
$35K |
| D0274 |
Bitewings - four radiographic images |
821 |
818 |
$28K |
| D1110 |
Prophylaxis - adult |
499 |
498 |
$27K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,680 |
1,675 |
$24K |
| D0220 |
Intraoral - periapical first radiographic image |
1,740 |
1,730 |
$22K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,677 |
1,672 |
$19K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
116 |
63 |
$12K |
| D0272 |
Bitewings - two radiographic images |
421 |
420 |
$10K |
| D1351 |
Sealant - per tooth |
256 |
57 |
$6K |
| D1330 |
|
39 |
39 |
$196.00 |
| D0603 |
|
458 |
454 |
$0.00 |
| D0602 |
|
622 |
621 |
$0.00 |
| D0601 |
|
303 |
303 |
$0.00 |