COMMONWEALTH MOBILE ORAL HEALTH SERVICES, LLC
NPI: 1215081625
· LAKEVILLE, MA 02347
· General Practice Dentistry
· NPI assigned 01/22/2007
$5.04M
Total Medicaid Paid
Provider Details
| Authorized Official | DOHERTY, MARK (DIRECTOR) |
| NPI Enumeration Date | 01/22/2007 |
Related Entities
Other providers sharing the same authorized official: DOHERTY, MARK
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
36,652 |
$1.18M |
| 2019 |
35,140 |
$1.12M |
| 2020 |
11,563 |
$381K |
| 2021 |
7,741 |
$279K |
| 2022 |
17,748 |
$608K |
| 2023 |
22,349 |
$807K |
| 2024 |
18,645 |
$666K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
21,015 |
20,246 |
$1.03M |
| D1208 |
Topical application of fluoride, excluding varnish |
26,597 |
25,718 |
$748K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
13,544 |
13,143 |
$724K |
| D1351 |
Sealant - per tooth |
16,837 |
4,211 |
$667K |
| D0274 |
Bitewings - four radiographic images |
11,512 |
11,312 |
$472K |
| D0120 |
Periodic oral evaluation - established patient |
13,337 |
12,892 |
$381K |
| D0230 |
Intraoral - periapical each additional radiographic image |
22,815 |
11,207 |
$345K |
| D1110 |
Prophylaxis - adult |
4,141 |
4,073 |
$273K |
| D0220 |
Intraoral - periapical first radiographic image |
11,476 |
11,242 |
$190K |
| D1206 |
Topical application of fluoride varnish |
5,285 |
5,237 |
$140K |
| D0272 |
Bitewings - two radiographic images |
1,569 |
1,497 |
$46K |
| D0140 |
Limited oral evaluation - problem focused |
379 |
374 |
$18K |
| D0190 |
|
257 |
227 |
$5K |
| D9920 |
|
153 |
150 |
$2K |
| D9410 |
|
836 |
820 |
$504.00 |
| D0601 |
|
25 |
25 |
$0.00 |
| D9450 |
|
60 |
60 |
$0.00 |