ELIZABETH SMILINE DENTAL, LLC
NPI: 1831498328
· ELIZABETH, NJ 07201
· Dentist
· NPI assigned 03/23/2011
$113K
Total Medicaid Paid
Provider Details
Related Entities
Other providers sharing the same authorized official: POLAVARAPU, USHA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
295 |
$8K |
| 2019 |
360 |
$14K |
| 2020 |
952 |
$21K |
| 2021 |
1,056 |
$22K |
| 2022 |
1,558 |
$31K |
| 2023 |
576 |
$12K |
| 2024 |
317 |
$5K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
1,477 |
538 |
$55K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
359 |
177 |
$13K |
| D1110 |
Prophylaxis - adult |
966 |
920 |
$13K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
720 |
694 |
$10K |
| D0210 |
Intraoral - complete series of radiographic images |
380 |
367 |
$6K |
| D2335 |
|
149 |
60 |
$6K |
| D2394 |
|
99 |
41 |
$3K |
| D0230 |
Intraoral - periapical each additional radiographic image |
350 |
317 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
428 |
400 |
$1K |
| D0191 |
|
73 |
70 |
$1K |
| D2332 |
|
20 |
12 |
$1K |
| D0120 |
Periodic oral evaluation - established patient |
42 |
41 |
$837.00 |
| D0274 |
Bitewings - four radiographic images |
51 |
50 |
$240.00 |