ALTA DENTAL OF MAINE, PC
NPI: 1528239910
· FREEPORT, ME 04032
· General Practice Dentistry
· NPI assigned 03/13/2008
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
139 |
$3K |
| 2019 |
367 |
$7K |
| 2020 |
133 |
$2K |
| 2021 |
106 |
$2K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
268 |
259 |
$7K |
| D1110 |
Prophylaxis - adult |
130 |
122 |
$4K |
| D1206 |
Topical application of fluoride varnish |
277 |
263 |
$3K |
| D1120 |
Prophylaxis - child |
26 |
25 |
$720.00 |
| D0274 |
Bitewings - four radiographic images |
31 |
28 |
$520.00 |
| D0140 |
Limited oral evaluation - problem focused |
13 |
13 |
$240.00 |