MAXINE V. CLARK, D.D.S., P.A.
NPI: 1083758460
· ELLICOTT CITY, MD 21042
· Dental Clinic/Center
· NPI assigned 02/17/2007
$932K
Total Medicaid Paid
Provider Details
| Authorized Official | CLARK, MAXINE (CEO) |
| NPI Enumeration Date | 02/17/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,899 |
$145K |
| 2019 |
1,972 |
$206K |
| 2020 |
1,908 |
$229K |
| 2021 |
2,191 |
$280K |
| 2022 |
961 |
$72K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D8670 |
Periodic orthodontic treatment visit |
6,492 |
5,995 |
$484K |
| D8080 |
Comprehensive orthodontic treatment of the adolescent dentition |
243 |
241 |
$249K |
| D8660 |
|
965 |
956 |
$143K |
| D9310 |
|
969 |
937 |
$46K |
| D0330 |
Panoramic radiographic image |
199 |
194 |
$8K |
| D1206 |
Topical application of fluoride varnish |
63 |
57 |
$2K |