CONVIVIAL DENTAL PC
NPI: 1689007908
· CHESTNUT HILL, MA 02467
· Multi-Specialty Clinic/Center
· NPI assigned 08/11/2013
$198K
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
362 |
$11K |
| 2019 |
363 |
$12K |
| 2020 |
231 |
$8K |
| 2021 |
984 |
$36K |
| 2022 |
1,139 |
$32K |
| 2023 |
1,332 |
$49K |
| 2024 |
1,494 |
$51K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
1,581 |
1,481 |
$77K |
| D1206 |
Topical application of fluoride varnish |
2,154 |
2,045 |
$54K |
| D0120 |
Periodic oral evaluation - established patient |
1,823 |
1,747 |
$50K |
| D1110 |
Prophylaxis - adult |
177 |
173 |
$10K |
| D0272 |
Bitewings - two radiographic images |
93 |
93 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
31 |
31 |
$2K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
20 |
13 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
26 |
26 |
$507.00 |