EL SHADDAI DENTAL ASSOCIATES MATTAPAN PC
NPI: 1376919696
· MATTAPAN, MA 02126
· Dentist
· NPI assigned 08/20/2015
$296K
Total Medicaid Paid
Provider Details
Related Entities
Other providers sharing the same authorized official: OLATUNJI, ANTHONY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
3,816 |
$153K |
| 2019 |
4,068 |
$142K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1351 |
Sealant - per tooth |
3,421 |
791 |
$120K |
| D1120 |
Prophylaxis - child |
1,419 |
1,400 |
$68K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,243 |
1,223 |
$55K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,506 |
1,487 |
$43K |
| D0120 |
Periodic oral evaluation - established patient |
267 |
267 |
$8K |
| D1110 |
Prophylaxis - adult |
28 |
28 |
$1K |