EAST GROVE FAMILY DENTAL INC.
NPI: 1578788303
· MIDDLEBORO, MA 02346
· General Practice Dentistry
· NPI assigned 04/16/2007
$230K
Total Medicaid Paid
Provider Details
| Authorized Official | BARTEK, GREGORY (VICE PRESIDENT) |
| NPI Enumeration Date | 04/16/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,648 |
$62K |
| 2019 |
1,621 |
$59K |
| 2020 |
1,334 |
$33K |
| 2021 |
529 |
$17K |
| 2022 |
507 |
$20K |
| 2023 |
419 |
$16K |
| 2024 |
534 |
$22K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,409 |
1,377 |
$76K |
| D0120 |
Periodic oral evaluation - established patient |
2,464 |
2,426 |
$63K |
| D1120 |
Prophylaxis - child |
988 |
984 |
$50K |
| D1206 |
Topical application of fluoride varnish |
781 |
779 |
$21K |
| D0274 |
Bitewings - four radiographic images |
484 |
480 |
$19K |
| D1208 |
Topical application of fluoride, excluding varnish |
15 |
15 |
$435.00 |
| D1999 |
|
451 |
398 |
$0.00 |