WYLIE SMILES PLLC

NPI: 1891164273 · WYLIE, TX 75098 · General Practice Dentistry · NPI assigned 09/16/2015

$25K

Total Medicaid Paid

381

Total Claims

207

Beneficiaries

Codes Billed

2018-01

First Month

2019-04

Last Month

Provider Details

Authorized Official	IQBAL, SYED (OWNER DENTIST)
NPI Enumeration Date	09/16/2015

Other providers sharing the same authorized official: IQBAL, SYED

Provider	City	State	Total Paid
MINTY SMILES	DUNCANVILLE	TX	$69K
SMILES SO WHITE PLLC	GARLAND	TX	$11K
SANGER DENTAL PLLC	SANGER	TX	$10K
PIONEER SMILES PLLC	IRVING	TX	$9K
BUDGET SMILES PLLC	GUN BARREL CITY	TX	$6K
GENESEE VALLEY CARDIOLOGY PLLC	DANSVILLE	NY	$5K

Year	Claims	Total Paid
2018	354	$25K
2019	27	$176.40

Code	Description	Claims	Beneficiaries	Total Paid
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	151	31	$16K
D2391	Resin-based composite - one surface, posterior, primary or permanent	71	17	$6K
D0150	Comprehensive oral evaluation - new or established patient	32	32	$1K
D0210	Intraoral - complete series of radiographic images	18	18	$706.40
D1208	Topical application of fluoride, excluding varnish	45	45	$661.50
D1110	Prophylaxis - adult	12	12	$603.68
D0603		52	52	$0.00