KOOL SMILES IN-3, PC

NPI: 1780983726 · LAFAYETTE, IN 47905 · Endodontist · NPI assigned 03/16/2011

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

Authorized official VIETH, DAVID controls 20+ related entities in our dataset. Read more

$5.15M

Total Medicaid Paid

172,274

Total Claims

134,382

Beneficiaries

Codes Billed

2018-01

First Month

2024-12

Last Month

Provider Details

Authorized Official	VIETH, DAVID (PRESIDENT)
NPI Enumeration Date	03/16/2011

Related Entities

Other providers sharing the same authorized official: VIETH, DAVID

Provider	City	State	Total Paid
DR. DAVID M. VIETH 2, P.C.	HAGERSTOWN	MD	$77.65M
DR DAVID M VIETH PC	TAKOMA PARK	MD	$45.71M
DR. DAVID M. VIETH 2, PC	BROOKLYN	MD	$35.07M
KOOL SMILES SC-2, PC	CHARLESTON	SC	$28.46M
DAVID M VIETH, DDS, A PROFESSIONAL CORPORATION	LAFAYETTE	LA	$22.57M
DAVID M. VIETH, DDS, A PROFESSIONAL CORPORATION	NEW ORLEANS	LA	$12.46M
DAVID M. VIETH DDS, A PROFESSIONAL CORPORATION	METAIRIE	LA	$11.51M
DAVID M VIETH DDS, A PROFESSIONAL CORPORATION	BATON ROUGE	LA	$10.61M
EAST 53RD STREET DENTAL-2, P.C.	INDIANAPOLIS	IN	$8.94M
DR. DAVID M. VIETH DDS, A PROFESSIONAL CORPORATION	GRETNA	LA	$7.23M
DAVID M VIETH DDS - A PROFESSIONAL CORPORATION	MONROE	LA	$7.21M
DAVID M VIETH DDS, A PROFESSIONAL CORPORATION	LAKE CHARLES	LA	$5.56M
DAVID M. VIETH DDS, A PROFESSIONAL CORPORATION	SHREVEPORT	LA	$4.92M
KOOL SMILES SC-2, PC	COLUMBIA	SC	$4.22M
KOOL SMILES IN-3, PC	ELKHART	IN	$3.26M
KOOL SMILES SC-2, PC	ORANGEBURG	SC	$3.00M
KOOL SMILES SC-2, PC	GREENVILLE	SC	$2.63M
KOOL SMILES SC-2, PC	ROCK HILL	SC	$2.02M
DR. DAVID M. VIETH 2, PC	SALISBURY	MD	$1.17M
KOOL SMILES SC-2, PC	ANDERSON	SC	$773K

Monthly Spending Trend

Yearly Breakdown

Year	Claims	Total Paid
2018	21,488	$84K
2019	21,786	$694K
2020	10,797	$273K
2021	24,734	$810K
2022	29,738	$967K
2023	31,653	$1.04M
2024	32,078	$1.28M

Billing Codes

Code	Description	Claims	Beneficiaries	Total Paid
D1351	Sealant - per tooth	23,816	5,912	$615K
D2930	Prefabricated stainless steel crown - primary tooth	4,044	2,102	$528K
D1120	Prophylaxis - child	16,138	15,097	$500K
D1206	Topical application of fluoride varnish	21,913	20,481	$432K
D0120	Periodic oral evaluation - established patient	17,587	16,498	$377K
D1110	Prophylaxis - adult	6,742	6,315	$303K
D9230	Inhalation of nitrous oxide / analgesia, anxiolysis	10,554	8,750	$283K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	3,141	1,935	$230K
D0272	Bitewings - two radiographic images	11,245	10,468	$226K
D7140	Extraction, erupted tooth or exposed root	2,650	1,603	$197K
D2140		3,763	2,376	$185K
D0150	Comprehensive oral evaluation - new or established patient	6,153	5,703	$177K
D2150	Silver amalgam - two surfaces, primary or permanent	2,625	1,784	$174K
D0210	Intraoral - complete series of radiographic images	4,723	4,229	$159K
D0274	Bitewings - four radiographic images	4,356	4,060	$122K
D2391	Resin-based composite - one surface, posterior, primary or permanent	2,423	1,589	$116K
D0220	Intraoral - periapical first radiographic image	10,948	9,962	$105K
D0140	Limited oral evaluation - problem focused	2,689	2,423	$85K
D0330	Panoramic radiographic image	2,586	2,252	$78K
D0230	Intraoral - periapical each additional radiographic image	9,694	7,225	$77K
D2332		377	248	$39K
D2393	Resin-based composite - three surfaces, posterior, primary or permanent	411	307	$38K
D3220	Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction	398	263	$34K
D7240	Removal of impacted tooth - completely bony	79	24	$27K
D1208	Topical application of fluoride, excluding varnish	627	617	$11K
D9920		275	241	$9K
D4346		53	53	$6K
D7111		84	66	$6K
D2330		54	38	$4K
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth	20	12	$3K
D1999		2,106	1,749	$15.00