Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

SMILE FRESH AH PC

NPI: 1922618487 · AUBURN HILLS, MI 48326 · General Practice Dentistry · NPI assigned 08/08/2020

$66K
Total Medicaid Paid
1,352
Total Claims
1,125
Beneficiaries
13
Codes Billed
2021-08
First Month
2024-10
Last Month

Provider Details

Authorized OfficialRAZIUDDIN, FAUZI (MANAGER)
NPI Enumeration Date08/08/2020

Related Entities

Other providers sharing the same authorized official: RAZIUDDIN, FAUZI

ProviderCityStateTotal Paid
SMILE FRESH PC GRAND BLANC MI $564K
SMILE FRESH TROY, P.C. TROY MI $5K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2021 46 $1K
2022 345 $16K
2023 460 $19K
2024 501 $30K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 188 87 $25K
D1120 Prophylaxis - child 335 335 $14K
D0120 Periodic oral evaluation - established patient 229 229 $7K
D1206 Topical application of fluoride varnish 185 185 $5K
D2393 Resin-based composite - three surfaces, posterior, primary or permanent 20 13 $3K
D2391 Resin-based composite - one surface, posterior, primary or permanent 28 13 $3K
D1351 Sealant - per tooth 61 13 $2K
D0220 Intraoral - periapical first radiographic image 92 91 $2K
D0150 Comprehensive oral evaluation - new or established patient 29 29 $1K
D0230 Intraoral - periapical each additional radiographic image 118 63 $1K
D1208 Topical application of fluoride, excluding varnish 42 42 $1K
D1110 Prophylaxis - adult 13 13 $785.43
D0274 Bitewings - four radiographic images 12 12 $435.56