CATHOLIC MEDICAL CENTER
NPI: 1194733691
· MANCHESTER, NH 03102
· Public Health Dentist
· NPI assigned 08/03/2006
$154K
Total Medicaid Paid
Provider Details
| Authorized Official | MERTZIC, PAUL (DIRECTOR, COMMUNITY HEALTH SERVICES) |
| NPI Enumeration Date | 08/03/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,447 |
$37K |
| 2019 |
1,204 |
$32K |
| 2020 |
104 |
$3K |
| 2021 |
216 |
$5K |
| 2022 |
328 |
$8K |
| 2023 |
939 |
$30K |
| 2024 |
1,053 |
$39K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
1,434 |
1,391 |
$43K |
| D1208 |
Topical application of fluoride, excluding varnish |
2,055 |
1,991 |
$39K |
| D1110 |
Prophylaxis - adult |
508 |
482 |
$31K |
| D1120 |
Prophylaxis - child |
775 |
754 |
$28K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
139 |
130 |
$7K |
| D0272 |
Bitewings - two radiographic images |
150 |
142 |
$3K |
| D1351 |
Sealant - per tooth |
40 |
13 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
164 |
153 |
$1K |
| D0274 |
Bitewings - four radiographic images |
26 |
26 |
$704.00 |