DEREK R BLACKWELDER DMD PLLC
NPI: 1427099233
· WINNISQUAM, NH 03289
· General Practice Dentistry
· NPI assigned 06/10/2006
$126K
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,177 |
$29K |
| 2019 |
950 |
$25K |
| 2020 |
559 |
$14K |
| 2021 |
666 |
$19K |
| 2022 |
578 |
$16K |
| 2023 |
439 |
$11K |
| 2024 |
392 |
$11K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
1,440 |
1,393 |
$42K |
| D1120 |
Prophylaxis - child |
1,074 |
1,030 |
$38K |
| D1206 |
Topical application of fluoride varnish |
1,703 |
1,645 |
$30K |
| D0272 |
Bitewings - two radiographic images |
352 |
338 |
$8K |
| D1110 |
Prophylaxis - adult |
166 |
165 |
$8K |
| D1330 |
|
14 |
14 |
$0.00 |
| D0603 |
|
12 |
12 |
$0.00 |