NPI: 1326304841 · SOMERVILLE, MA 02145 · General Practice Dentistry · NPI assigned 04/10/2012
| Authorized Official | WAGNER, KATIE-ROSE (PRESIDENT) |
| NPI Enumeration Date | 04/10/2012 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 1,947 | $69K |
| 2019 | 1,327 | $47K |
| 2020 | 983 | $31K |
| 2021 | 919 | $28K |
| 2022 | 1,266 | $43K |
| 2023 | 1,388 | $48K |
| 2024 | 1,167 | $43K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 2,259 | 2,200 | $111K |
| D0274 | Bitewings - four radiographic images | 2,480 | 2,415 | $88K |
| D0120 | Periodic oral evaluation - established patient | 2,509 | 2,451 | $57K |
| D1120 | Prophylaxis - child | 650 | 642 | $31K |
| D1208 | Topical application of fluoride, excluding varnish | 551 | 543 | $15K |
| D1206 | Topical application of fluoride varnish | 274 | 270 | $7K |
| D0220 | Intraoral - periapical first radiographic image | 182 | 173 | $3K |
| D0230 | Intraoral - periapical each additional radiographic image | 16 | 12 | $191.00 |
| D1999 | 76 | 72 | $0.00 |