POLISHED DNTL LLC
NPI: 1124672779
· CHATHAM, MA 02633
· Dental Hygienist
· NPI assigned 07/31/2019
$3.42M
Total Medicaid Paid
Provider Details
| Authorized Official | GOULD, ELLEN (OWNER) |
| NPI Enumeration Date | 07/31/2019 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
13,785 |
$470K |
| 2020 |
3,710 |
$126K |
| 2021 |
8,665 |
$317K |
| 2022 |
29,303 |
$823K |
| 2023 |
29,414 |
$891K |
| 2024 |
24,032 |
$790K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1351 |
Sealant - per tooth |
30,831 |
8,705 |
$1.16M |
| D1120 |
Prophylaxis - child |
16,014 |
14,572 |
$774K |
| D0190 |
|
27,674 |
24,878 |
$693K |
| D1206 |
Topical application of fluoride varnish |
27,071 |
24,343 |
$669K |
| D1354 |
|
6,202 |
1,755 |
$79K |
| D1110 |
Prophylaxis - adult |
337 |
325 |
$20K |
| D9450 |
|
603 |
601 |
$17K |
| D9410 |
|
177 |
172 |
$6K |