ELEVATE DENTAL EXTRACTIONS
NPI: 1457933095
· ELLSWORTH, ME 04605
· Dental Clinic/Center
· NPI assigned 04/23/2021
$168K
Total Medicaid Paid
Provider Details
| Authorized Official | ROY, MARY (OFFICE MANAGER) |
| NPI Enumeration Date | 04/23/2021 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
278 |
$24K |
| 2023 |
829 |
$76K |
| 2024 |
768 |
$67K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7140 |
Extraction, erupted tooth or exposed root |
1,040 |
196 |
$113K |
| D0140 |
Limited oral evaluation - problem focused |
454 |
438 |
$23K |
| D0330 |
Panoramic radiographic image |
314 |
306 |
$23K |
| D7250 |
|
67 |
13 |
$8K |