WHITE BEAR LAKE ORTHODONTICS
NPI: 1730782467
· WHITE BEAR LAKE, MN 55110
· Orthodontics and Dentofacial Orthopedic Dentist
· NPI assigned 11/17/2020
$844K
Total Medicaid Paid
Provider Details
| Authorized Official | SMITH, TAMARA (OWNER/ORTHODONTIST) |
| NPI Enumeration Date | 11/17/2020 |
Related Entities
Other providers sharing the same authorized official: SMITH, TAMARA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
763 |
$152K |
| 2023 |
2,197 |
$409K |
| 2024 |
1,641 |
$283K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D8080 |
|
1,820 |
1,812 |
$434K |
| D8670 |
|
1,529 |
1,461 |
$280K |
| D8020 |
|
198 |
197 |
$54K |
| D0330 |
|
342 |
334 |
$22K |
| D0350 |
|
288 |
283 |
$22K |
| D0340 |
|
203 |
201 |
$19K |
| D0470 |
|
142 |
140 |
$9K |
| D0150 |
|
79 |
78 |
$4K |