SMILES 4 KIDS JEROME PLLC
NPI: 1811683097
· JEROME, ID 83338
· Pediatric Dentist
· NPI assigned 04/12/2023
$145K
Total Medicaid Paid
Provider Details
| Authorized Official | SPORIN, LEANN (OFFICE MANAGER) |
| NPI Enumeration Date | 04/12/2023 |
Related Entities
Other providers sharing the same authorized official: SPORIN, LEANN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
1,488 |
$20K |
| 2024 |
7,684 |
$124K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
|
1,087 |
1,087 |
$72K |
| D1110 |
|
347 |
347 |
$36K |
| D2392 |
|
205 |
140 |
$21K |
| D0150 |
|
56 |
56 |
$4K |
| D2391 |
|
45 |
37 |
$3K |
| D0145 |
|
41 |
41 |
$3K |
| D0330 |
|
36 |
36 |
$3K |
| D2930 |
|
35 |
12 |
$2K |
| D1351 |
|
411 |
80 |
$951.16 |
| D0120 |
|
1,156 |
1,156 |
$206.32 |
| D9230 |
|
416 |
398 |
$105.96 |
| D0274 |
|
303 |
303 |
$80.47 |
| D0220 |
|
1,226 |
1,222 |
$10.51 |
| D1206 |
|
1,462 |
1,462 |
$0.00 |
| D0272 |
|
868 |
868 |
$0.00 |
| D0230 |
|
1,360 |
1,156 |
$0.00 |
| D9986 |
|
118 |
116 |
$0.00 |