VILLAGE SMILES
NPI: 1386922565
· LIMERICK, ME 04048
· Dental Hygienist
· NPI assigned 07/22/2011
$381K
Total Medicaid Paid
Provider Details
| Authorized Official | CRANDALL, TERESA (INDEPENDENT DENTAL HYGIENIST) |
| NPI Enumeration Date | 07/22/2011 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,305 |
$25K |
| 2019 |
1,249 |
$25K |
| 2020 |
907 |
$18K |
| 2021 |
1,480 |
$30K |
| 2022 |
1,975 |
$51K |
| 2023 |
3,029 |
$94K |
| 2024 |
4,241 |
$139K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
3,359 |
3,315 |
$125K |
| D1208 |
Topical application of fluoride, excluding varnish |
5,060 |
4,975 |
$89K |
| D1110 |
Prophylaxis - adult |
1,086 |
1,063 |
$59K |
| D0190 |
|
2,383 |
2,351 |
$50K |
| D1310 |
|
1,378 |
1,367 |
$31K |
| D0274 |
Bitewings - four radiographic images |
326 |
320 |
$13K |
| D1351 |
Sealant - per tooth |
353 |
56 |
$8K |
| D1354 |
|
116 |
38 |
$3K |
| D0210 |
Intraoral - complete series of radiographic images |
12 |
12 |
$1K |
| D1330 |
|
70 |
68 |
$914.06 |
| D0272 |
Bitewings - two radiographic images |
25 |
25 |
$848.45 |
| D1206 |
Topical application of fluoride varnish |
18 |
18 |
$216.00 |