HEALTHY SMILES LLC
NPI: 1811775711
· OGDENSBURG, WI 54962
· Dental Hygienist
· NPI assigned 09/20/2023
$231K
Total Medicaid Paid
Provider Details
| Authorized Official | BESTUL, AIMEE (OWNER/PROVIDER) |
| NPI Enumeration Date | 09/20/2023 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
5,151 |
$64K |
| 2024 |
13,900 |
$167K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1351 |
Sealant - per tooth |
6,798 |
2,031 |
$124K |
| D1206 |
Topical application of fluoride varnish |
4,043 |
4,024 |
$58K |
| D0191 |
|
4,104 |
4,085 |
$49K |
| D0603 |
|
4,106 |
4,087 |
$0.00 |