SMILE DENTAL REVERE LLC
NPI: 1679209340
· REVERE, MA 02151
· Dentist
· NPI assigned 07/26/2022
Provider Details
| Authorized Official | YANOVSKY, BELLA (MANAGER) |
| NPI Enumeration Date | 07/26/2022 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
188 |
$6K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
42 |
42 |
$2K |
| D1208 |
Topical application of fluoride, excluding varnish |
47 |
47 |
$1K |
| D0274 |
Bitewings - four radiographic images |
22 |
20 |
$843.00 |
| D1120 |
Prophylaxis - child |
13 |
13 |
$715.00 |
| D0220 |
Intraoral - periapical first radiographic image |
29 |
26 |
$498.00 |
| D0120 |
Periodic oral evaluation - established patient |
13 |
13 |
$363.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
22 |
20 |
$317.00 |