CARTA, TRIS
NPI: 1144224411
· MANCHESTER, CT 06040
· Dentist
· NPI assigned 06/02/2005
$131K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
580 |
$17K |
| 2019 |
696 |
$21K |
| 2020 |
484 |
$15K |
| 2021 |
831 |
$23K |
| 2022 |
702 |
$20K |
| 2023 |
620 |
$18K |
| 2024 |
473 |
$16K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
1,167 |
1,135 |
$50K |
| D0120 |
Periodic oral evaluation - established patient |
1,817 |
1,751 |
$48K |
| D1110 |
Prophylaxis - adult |
621 |
595 |
$16K |
| D1208 |
Topical application of fluoride, excluding varnish |
394 |
381 |
$10K |
| D0220 |
Intraoral - periapical first radiographic image |
232 |
216 |
$3K |
| D0274 |
Bitewings - four radiographic images |
45 |
43 |
$2K |
| D0230 |
Intraoral - periapical each additional radiographic image |
78 |
69 |
$962.88 |
| D1206 |
Topical application of fluoride varnish |
32 |
32 |
$909.44 |