Medicaid Provider Spending
$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
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GREAT SMILES LLC
NPI: 1740913268 · TOA ALTA, PR 00953 ·
1223D0001X
$9K
Total Medicaid Paid
430
Total Claims
427
Beneficiaries
7
Codes Billed
2024-10
First Month
2024-12
Last Month
Monthly Spending Trend
Yearly Breakdown
Year
Claims
Total Paid
2024
430
$9K
Billing Codes
Code
Description
Claims
Beneficiaries
Total Paid
D1110
86
86
$3K
D1999
139
136
$2K
D0120
77
77
$1K
D0272
75
75
$1K
D0330
17
17
$640.00
D1208
24
24
$355.92
D0150
12
12
$275.00