MOUNT AIRY DENTAL CENTER
NPI: 1205422573
· MOUNT AIRY, MD 21771
· Dental Clinic/Center
· NPI assigned 12/21/2020
$208K
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
14 |
$323.96 |
| 2023 |
1,030 |
$60K |
| 2024 |
1,520 |
$147K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D2750 |
|
199 |
98 |
$98K |
| D0140 |
Limited oral evaluation - problem focused |
696 |
558 |
$33K |
| D1110 |
Prophylaxis - adult |
447 |
438 |
$29K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
261 |
252 |
$14K |
| D2950 |
|
139 |
71 |
$12K |
| D0210 |
Intraoral - complete series of radiographic images |
197 |
189 |
$11K |
| D0120 |
Periodic oral evaluation - established patient |
159 |
159 |
$5K |
| D0220 |
Intraoral - periapical first radiographic image |
347 |
337 |
$4K |
| D1206 |
Topical application of fluoride varnish |
68 |
65 |
$2K |
| D0274 |
Bitewings - four radiographic images |
12 |
12 |
$288.84 |
| D0230 |
Intraoral - periapical each additional radiographic image |
39 |
39 |
$262.40 |