MONTSHIRE HENNIKER PC
NPI: 1598400400
· HENNIKER, NH 03242
· Pediatric Dentist
· NPI assigned 05/04/2022
$334K
Total Medicaid Paid
Provider Details
| Authorized Official | NORRIS, JONATHAN (PEDIATRIC DENTIST) |
| NPI Enumeration Date | 05/04/2022 |
Related Entities
Other providers sharing the same authorized official: NORRIS, JONATHAN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
862 |
$26K |
| 2023 |
3,724 |
$113K |
| 2024 |
6,426 |
$196K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1354 |
|
4,369 |
810 |
$139K |
| D1351 |
Sealant - per tooth |
2,111 |
350 |
$70K |
| D1120 |
Prophylaxis - child |
1,256 |
1,217 |
$48K |
| D1206 |
Topical application of fluoride varnish |
1,218 |
1,183 |
$25K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
258 |
254 |
$16K |
| D0272 |
Bitewings - two radiographic images |
402 |
388 |
$12K |
| D1110 |
Prophylaxis - adult |
133 |
129 |
$8K |
| D0274 |
Bitewings - four radiographic images |
167 |
155 |
$6K |
| D2940 |
|
81 |
26 |
$5K |
| D0330 |
Panoramic radiographic image |
76 |
72 |
$4K |
| D0120 |
Periodic oral evaluation - established patient |
85 |
84 |
$3K |
| D0603 |
|
799 |
758 |
$0.00 |
| D1330 |
|
44 |
44 |
$0.00 |
| D9996 |
|
13 |
13 |
$0.00 |