Medicaid Provider Spending

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

RENTON SMILE DENTISTRY

NPI: 1982092805 · RENTON, WA 98057 · Dental Clinic/Center · NPI assigned 12/30/2014

$1K
Total Medicaid Paid
97
Total Claims
87
Beneficiaries
4
Codes Billed
2018-01
First Month
2018-02
Last Month

Provider Details

Authorized OfficialMANCHESTER, ELIZABETH (DENTIST/OWNER)
NPI Enumeration Date12/30/2014

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 97 $1K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0120 Periodic oral evaluation - established patient 34 30 $624.21
D1206 Topical application of fluoride varnish 36 31 $410.75
D0220 Intraoral - periapical first radiographic image 13 13 $101.48
D0230 Intraoral - periapical each additional radiographic image 14 13 $29.82