MAIDSTONE DENTAL
NPI: 1184862070
· NEW KENT, VA 23124
· General Practice Dentistry
· NPI assigned 01/30/2009
$103K
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
891 |
$22K |
| 2019 |
931 |
$23K |
| 2020 |
623 |
$15K |
| 2021 |
769 |
$20K |
| 2022 |
621 |
$18K |
| 2023 |
394 |
$6K |
| 2024 |
205 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
1,645 |
1,629 |
$29K |
| D1206 |
Topical application of fluoride varnish |
1,309 |
1,298 |
$27K |
| D1120 |
Prophylaxis - child |
811 |
808 |
$25K |
| D1110 |
Prophylaxis - adult |
573 |
567 |
$21K |
| D0274 |
Bitewings - four radiographic images |
84 |
79 |
$1K |
| D0272 |
Bitewings - two radiographic images |
12 |
12 |
$241.80 |