PREMIER DENTAL PARTNERS, LLC
NPI: 1699960724
· NOTTINGHAM, MD 21236
· General Practice Dentistry
· NPI assigned 09/11/2007
$138K
Total Medicaid Paid
Provider Details
| Authorized Official | MATHEWS, BOB (GENERAL DENTIST) |
| NPI Enumeration Date | 09/11/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,085 |
$28K |
| 2019 |
1,165 |
$31K |
| 2020 |
747 |
$18K |
| 2021 |
534 |
$14K |
| 2022 |
456 |
$12K |
| 2023 |
739 |
$20K |
| 2024 |
601 |
$16K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1206 |
Topical application of fluoride varnish |
1,572 |
1,539 |
$39K |
| D0120 |
Periodic oral evaluation - established patient |
1,271 |
1,244 |
$37K |
| D1110 |
Prophylaxis - adult |
594 |
578 |
$35K |
| D1120 |
Prophylaxis - child |
179 |
177 |
$8K |
| D0274 |
Bitewings - four radiographic images |
292 |
280 |
$6K |
| D0220 |
Intraoral - periapical first radiographic image |
564 |
546 |
$5K |
| D0230 |
Intraoral - periapical each additional radiographic image |
406 |
391 |
$3K |
| D1330 |
|
419 |
405 |
$3K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
17 |
13 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
13 |
13 |
$669.50 |