Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › MI › JACKSON › PURA VIDA SMILES, PC

PURA VIDA SMILES, PC

NPI: 1740602846 · JACKSON, MI 49202 · Dentist · NPI assigned 01/09/2014

$8K
Total Medicaid Paid
176
Total Claims
174
Beneficiaries
3
Codes Billed
2019-08
First Month
2024-11
Last Month

Provider Details

Authorized OfficialBERTOLLINI, JASON (PRM)
NPI Enumeration Date01/09/2014

Related Entities

Other providers sharing the same authorized official: BERTOLLINI, JASON

ProviderCityStateTotal Paid
TAWFIQ ALKILANI DDS PLLC TRAVERSE CITY MI $360K
PLEASANT SMILES DENTAL CARE, PLLC MT PLEASANT MI $315K
GILL DENTAL PC LANSING MI $195K
PLEV BC PLC EAST SYRACUSE NY $142K
DR. ELDIB, PLLC ADRIAN MI $81K
EPP OREGON LLC TUALATIN OR $57K
PLEV SAG, PLC SAGINAW MI $27K
PLEV, PC FLINT MI $9K
VMLP AH PLC LAKE ORION MI $1K
SCOTT NIGL DENTAL PC FORT GRATIOT MI $501.00

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2019 13 $225.00
2024 163 $7K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0150 Comprehensive oral evaluation - new or established patient 97 96 $4K
D0210 Intraoral - complete series of radiographic images 66 65 $4K
D1206 Topical application of fluoride varnish 13 13 $225.00