Clinic
Great Dental Clinic PC
Great Dental Clinic PC was paid $88K by Medicaid between May 2023 and Nov 2024, across 9 billing codes. Its largest line is D1110, Prophylaxis - adult — 33% of everything it billed.
33Billing provider infoGREAT DENTAL CLINIC PC
WINCHENDON, MA 01475
WINCHENDON, MA 01475
33aNPI1174221311assigned 02/17/2023
33bProvider typeDental Clinic/Center
28Total paid$88K
24GClaims2,795
24DCodes billed9
24AFirst – last monthMay 2023 – Nov 2024
Compared with peers
Next to other Dental Clinic/Center providers in Massachusetts
Rank by total paid#195 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 | |
|---|---|---|---|
| 2023 | 1,146 | $35K | |
| 2024incomplete | 1,649 | $53K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 33% | 493 | 484 | $29K |
| D0274 | Bitewings - four radiographic images | 20% | 452 | 444 | $18K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 15% | 531 | 522 | $14K |
| D0220 | Intraoral - periapical first radiographic image | 9.8% | 508 | 488 | $9K |
| D1208 | Topical application of fluoride, excluding varnish | 9.2% | 266 | 261 | $8K |
| D0230 | Intraoral - periapical each additional radiographic image | 7.7% | 477 | 453 | $7K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 2.2% | 27 | 12 | $2K |
| D1120 | Dental cleaning, childProphylaxis - child | 1.7% | 29 | 29 | $2K |
| D0210 | Intraoral - complete series of radiographic images | 1.1% | 12 | 12 | $966.00 |
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 officialHAKWATI, AHMAD (OWNER)