POLISHED ORAL HEALTH, LLC
NPI: 1346948171
· FORT KENT, ME 04743
· Dental Hygienist
· NPI assigned 02/21/2023
$376K
Total Medicaid Paid
Provider Details
| Authorized Official | MORIN, LUCY (OWNER) |
| NPI Enumeration Date | 02/21/2023 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
5,999 |
$124K |
| 2024 |
11,967 |
$252K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1206 |
Topical application of fluoride varnish |
4,074 |
4,016 |
$87K |
| D1330 |
|
3,940 |
3,893 |
$84K |
| D1310 |
|
3,966 |
3,835 |
$77K |
| D0190 |
|
4,264 |
4,195 |
$76K |
| D1351 |
Sealant - per tooth |
649 |
183 |
$17K |
| D1120 |
Prophylaxis - child |
311 |
289 |
$15K |
| D1354 |
|
528 |
169 |
$13K |
| D1355 |
|
192 |
56 |
$4K |
| D1110 |
Prophylaxis - adult |
42 |
41 |
$3K |