Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › NM › BELEN › ENCHANTED SMILES

ENCHANTED SMILES

NPI: 1821430968 · BELEN, NM 87002 · Dental Hygienist · NPI assigned 07/17/2013

$672.10
Total Medicaid Paid
26
Total Claims
26
Beneficiaries
2
Codes Billed
2024-10
First Month
2024-10
Last Month

Provider Details

Authorized OfficialMONTOYA, DEANNA (OWNER)
NPI Enumeration Date07/17/2013

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2024 26 $672.10

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1120 Prophylaxis - child 12 12 $402.20
D1206 Topical application of fluoride varnish 14 14 $269.90