Clinic
Fresh Pond Dental LLC
Fresh Pond Dental LLC was paid $110K by Medicaid between Jan 2018 and Nov 2019, across 13 billing codes. Its largest line is D1110, Prophylaxis - adult — 40% of everything it billed.
33Billing provider infoFRESH POND DENTAL LLC
CAMBRIDGE, MA 02138
CAMBRIDGE, MA 02138
33aNPI1134496904assigned 11/22/2011
33bProvider typeDental Clinic/Center
28Total paid$110K
24GClaims2,883
24DCodes billed13
24AFirst – last monthJan 2018 – Nov 2019
Compared with peers
Next to other Dental Clinic/Center providers in Massachusetts
Rank by total paid#191 of 307
Median peer was paid$245K
This provider vs. median0.4×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 1,740 | $65K | |
| 2019 | 1,143 | $45K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 40% | 886 | 860 | $44K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 13% | 645 | 625 | $14K |
| D0274 | Bitewings - four radiographic images | 12% | 368 | 359 | $13K |
| D0210 | Intraoral - complete series of radiographic images | 7.7% | 124 | 119 | $8K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 6.0% | 81 | 56 | $7K |
| D0150 | Comprehensive oral evaluation - new or established patient | 5.2% | 138 | 135 | $6K |
| D4341 | 4.4% | 56 | 14 | $5K | |
| D0220 | Intraoral - periapical first radiographic image | 3.6% | 278 | 265 | $4K |
| D1208 | Topical application of fluoride, excluding varnish | 2.6% | 98 | 98 | $3K |
| D0140 | Limited oral evaluation - problem focused | 2.5% | 69 | 66 | $3K |
| D1120 | Dental cleaning, childProphylaxis - child | 2.0% | 42 | 42 | $2K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | <1% | 14 | 12 | $1K |
1 more codes
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 84 | $998.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialMAZO, ANDREY (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Arena Dental LLC | Worcester, MA | $192K |
| Andrey Mazo DMD PC | Worcester, MA | $151K |
| All Dental of Revere | Revere, MA | $2K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.