FOSTER STREET DENTAL, LLC
NPI: 1255639035
· PEABODY, MA 01960
· Dentist
· NPI assigned 03/03/2011
$343K
Total Medicaid Paid
Provider Details
| Authorized Official | MALO, BIPLAB (PRESIDENT) |
| NPI Enumeration Date | 03/03/2011 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,728 |
$56K |
| 2019 |
1,739 |
$56K |
| 2020 |
1,066 |
$37K |
| 2021 |
1,475 |
$45K |
| 2022 |
2,126 |
$58K |
| 2023 |
1,855 |
$54K |
| 2024 |
1,487 |
$37K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
2,223 |
2,170 |
$118K |
| D0120 |
Periodic oral evaluation - established patient |
2,560 |
2,497 |
$60K |
| D0274 |
Bitewings - four radiographic images |
1,688 |
1,635 |
$59K |
| D0220 |
Intraoral - periapical first radiographic image |
2,154 |
2,082 |
$33K |
| D1208 |
Topical application of fluoride, excluding varnish |
853 |
831 |
$24K |
| D1120 |
Prophylaxis - child |
357 |
351 |
$17K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,267 |
1,206 |
$16K |
| D0140 |
Limited oral evaluation - problem focused |
255 |
246 |
$10K |
| D0330 |
Panoramic radiographic image |
77 |
75 |
$5K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
42 |
38 |
$2K |