Medicaid Provider Spending

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

SIMPLY SMILES LLC

NPI: 1982451605 · MONMOUTH, ME 04259 · Dental Hygienist · NPI assigned 05/01/2024

$104K
Total Medicaid Paid
3,926
Total Claims
1,125
Beneficiaries
12
Codes Billed
2024-09
First Month
2024-12
Last Month

Provider Details

Authorized OfficialLALIBERTE, SHERRY (PRACTICE OWNER)
NPI Enumeration Date05/01/2024

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2024 3,926 $104K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1355 1,829 112 $36K
D2940 306 70 $18K
D1351 Sealant - per tooth 494 87 $15K
D1354 495 78 $12K
D1120 Prophylaxis - child 122 122 $7K
D0190 185 162 $4K
D1208 Topical application of fluoride, excluding varnish 130 130 $3K
D1310 138 138 $3K
D0272 Bitewings - two radiographic images 85 84 $3K
D1330 43 43 $1K
D1206 Topical application of fluoride varnish 43 43 $1K
D0603 56 56 $0.00