DR DENTAL OF MANCHESTER PC
NPI: 1356854426
· MANCHESTER, NH 03101
· Dental Clinic/Center
· NPI assigned 11/13/2017
Provider Details
| Authorized Official | CHAMPAGNE, SHEILA (ACCOUNTS PAYABLE) |
| NPI Enumeration Date | 11/13/2017 |
Related Entities
Other providers sharing the same authorized official: CHAMPAGNE, SHEILA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
49 |
$2K |
| 2019 |
1,163 |
$27K |
| 2020 |
88 |
$2K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
211 |
154 |
$8K |
| D0140 |
Limited oral evaluation - problem focused |
229 |
183 |
$8K |
| D1120 |
Prophylaxis - child |
206 |
151 |
$5K |
| D1208 |
Topical application of fluoride, excluding varnish |
275 |
208 |
$4K |
| D7140 |
Extraction, erupted tooth or exposed root |
36 |
15 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
279 |
232 |
$2K |
| D0120 |
Periodic oral evaluation - established patient |
16 |
13 |
$396.50 |
| D1110 |
Prophylaxis - adult |
13 |
12 |
$371.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
35 |
29 |
$140.00 |