MOUNT DESERT ISLAND HOSPITAL
NPI: 1235553413
· SOUTHWEST HARBOR, ME 04679
· Dental Clinic/Center
· NPI assigned 02/10/2014
Provider Details
| Authorized Official | ABBOTT, JENNIFER (DIR. MEDICAL STAFF SUPPORT & QUALIT) |
| Parent Organization | MOUNT DESERT ISLAND HOSPITAL |
| NPI Enumeration Date | 02/10/2014 |
Related Entities
Other providers sharing the same authorized official: ABBOTT, JENNIFER
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
225 |
$4K |
| 2019 |
178 |
$3K |
| 2020 |
155 |
$3K |
| 2021 |
178 |
$5K |
| 2022 |
149 |
$4K |
| 2023 |
423 |
$14K |
| 2024 |
459 |
$20K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1206 |
Topical application of fluoride varnish |
784 |
751 |
$13K |
| D1110 |
Prophylaxis - adult |
164 |
151 |
$9K |
| D0140 |
Limited oral evaluation - problem focused |
258 |
229 |
$9K |
| D1120 |
Prophylaxis - child |
253 |
234 |
$8K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
100 |
59 |
$8K |
| D0120 |
Periodic oral evaluation - established patient |
91 |
82 |
$2K |
| D0274 |
Bitewings - four radiographic images |
49 |
38 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
12 |
12 |
$797.64 |
| D0190 |
|
16 |
16 |
$354.56 |
| D0220 |
Intraoral - periapical first radiographic image |
40 |
38 |
$296.00 |