MARK R HARRISON DDS PA

NPI: 1508875329 · EXETER, NH 03833 · Pediatric Dentist · NPI assigned 08/08/2006

$66K

Total Medicaid Paid

3,016

Total Claims

2,961

Beneficiaries

Codes Billed

2018-01

First Month

2019-03

Last Month

Provider Details

Authorized Official	HARRISON, MARK (DENTIST / PRESIDENT)
NPI Enumeration Date	08/08/2006

Other providers sharing the same authorized official: HARRISON, MARK

Provider	City	State	Total Paid
UNIVERSITY PEDIATRICIANS	DETROIT	MI	$107.02M
UNIVERSITY PEDIATRICIANS AUTISM CENTER	NOVI	MI	$9.14M
UNIVERSITY PEDIATRICIANS	DETROIT	MI	$2.01M
VALLEY CANCER ASSOCIATES PA	HARLINGEN	TX	$1.33M

Year	Claims	Total Paid
2018	2,419	$52K
2019	597	$13K

Code	Description	Claims	Beneficiaries	Total Paid
D0120	Periodic oral evaluation - established patient	698	693	$19K
D1120	Prophylaxis - child	420	419	$14K
D1110	Prophylaxis - adult	286	282	$13K
D1208	Topical application of fluoride, excluding varnish	669	664	$11K
D0272	Bitewings - two radiographic images	140	140	$3K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	29	12	$3K
D0274	Bitewings - four radiographic images	39	39	$1K
D1330		704	700	$0.00
D1352		31	12	$0.00