MILES OF SMILES DENTAL GROUP
NPI: 1922535079
· IOWA FALLS, IA 50126
· Dental Clinic/Center
· NPI assigned 05/19/2017
$125K
Total Medicaid Paid
Provider Details
| Authorized Official | O'KANE, PAUL (PARTNER) |
| NPI Enumeration Date | 05/19/2017 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,198 |
$22K |
| 2019 |
1,284 |
$22K |
| 2020 |
841 |
$17K |
| 2021 |
697 |
$16K |
| 2022 |
848 |
$20K |
| 2023 |
843 |
$20K |
| 2024 |
279 |
$8K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
2,662 |
2,531 |
$52K |
| D1110 |
Prophylaxis - adult |
667 |
645 |
$25K |
| D1120 |
Prophylaxis - child |
823 |
744 |
$23K |
| D1206 |
Topical application of fluoride varnish |
1,276 |
1,169 |
$19K |
| D1208 |
Topical application of fluoride, excluding varnish |
243 |
215 |
$3K |
| D0272 |
Bitewings - two radiographic images |
88 |
68 |
$1K |
| D1351 |
Sealant - per tooth |
47 |
12 |
$1K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
20 |
12 |
$290.40 |
| D1330 |
|
164 |
147 |
$0.00 |