CHILDRENS DENTISTRY OF WESTERLY LLC
NPI: 1497980924
· WESTERLY, RI 02891
· Pediatric Dentist
· NPI assigned 05/28/2009
$249K
Total Medicaid Paid
Provider Details
| Authorized Official | SHANNON, BRIAN (OWNER) |
| NPI Enumeration Date | 05/28/2009 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
2,068 |
$61K |
| 2019 |
1,898 |
$61K |
| 2020 |
1,603 |
$53K |
| 2021 |
2,049 |
$69K |
| 2022 |
135 |
$5K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
2,474 |
2,392 |
$102K |
| D0120 |
Periodic oral evaluation - established patient |
2,284 |
2,189 |
$69K |
| D1208 |
Topical application of fluoride, excluding varnish |
2,503 |
2,421 |
$64K |
| D0272 |
Bitewings - two radiographic images |
492 |
473 |
$14K |