SUPER SMILES FOR KIDS, LLC
NPI: 1750747150
· MARICOPA, AZ 85139
· Pediatric Dentist
· NPI assigned 01/14/2016
Provider Details
| Authorized Official | ROPER, MATTHEW (OWNER/DENTIST) |
| NPI Enumeration Date | 01/14/2016 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
13 |
$233.79 |
| 2021 |
28 |
$561.94 |
| 2022 |
240 |
$6K |
| 2023 |
712 |
$16K |
| 2024 |
2,090 |
$61K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
548 |
536 |
$22K |
| D1206 |
Topical application of fluoride varnish |
842 |
818 |
$17K |
| D0120 |
Periodic oral evaluation - established patient |
607 |
593 |
$16K |
| D0274 |
Bitewings - four radiographic images |
354 |
346 |
$11K |
| D0240 |
|
351 |
252 |
$7K |
| D1110 |
Prophylaxis - adult |
128 |
123 |
$6K |
| D1351 |
Sealant - per tooth |
46 |
14 |
$1K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
29 |
29 |
$1K |
| D0272 |
Bitewings - two radiographic images |
54 |
54 |
$1K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
19 |
17 |
$481.00 |
| D0220 |
Intraoral - periapical first radiographic image |
29 |
29 |
$431.52 |
| D0603 |
|
76 |
75 |
$0.00 |