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GREATER DERRY ORAL HEALTH COLLABORATIVE CORPORATION
GREATER DERRY ORAL HEALTH COLLABORATIVE CORPORATION
NPI: 1235431610
· DERRY, NH 03038
· Dental Hygienist
· NPI assigned 11/17/2010
$167K
Total Medicaid Paid
Provider Details
| Authorized Official | POWERS, DIANNE (EXECUTIVE DIRECTOR) |
| NPI Enumeration Date | 11/17/2010 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,370 |
$29K |
| 2019 |
1,029 |
$21K |
| 2020 |
569 |
$12K |
| 2021 |
842 |
$21K |
| 2022 |
1,187 |
$33K |
| 2023 |
1,067 |
$29K |
| 2024 |
766 |
$22K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1351 |
Sealant - per tooth |
3,394 |
624 |
$87K |
| D1120 |
Prophylaxis - child |
1,483 |
1,311 |
$46K |
| D1206 |
Topical application of fluoride varnish |
994 |
898 |
$17K |
| D1208 |
Topical application of fluoride, excluding varnish |
856 |
732 |
$13K |
| D1110 |
Prophylaxis - adult |
85 |
79 |
$4K |
| D1353 |
|
18 |
17 |
$0.00 |