METHUEN SMILES LLC
NPI: 1366972747
· METHUEN, MA 01844
· General Practice Dentistry
· NPI assigned 06/18/2017
$200K
Total Medicaid Paid
Provider Details
| Authorized Official | MAHAJAN, JYOTI (DENTIST) |
| NPI Enumeration Date | 06/18/2017 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
735 |
$26K |
| 2019 |
724 |
$24K |
| 2020 |
902 |
$31K |
| 2021 |
812 |
$24K |
| 2022 |
870 |
$30K |
| 2023 |
869 |
$31K |
| 2024 |
949 |
$35K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,107 |
1,060 |
$59K |
| D0120 |
Periodic oral evaluation - established patient |
1,865 |
1,792 |
$45K |
| D1206 |
Topical application of fluoride varnish |
1,323 |
1,288 |
$33K |
| D1120 |
Prophylaxis - child |
629 |
609 |
$30K |
| D0274 |
Bitewings - four radiographic images |
699 |
670 |
$24K |
| D0330 |
Panoramic radiographic image |
67 |
63 |
$4K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
57 |
57 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
69 |
66 |
$1K |
| D0230 |
Intraoral - periapical each additional radiographic image |
45 |
38 |
$576.00 |