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PEDIATRIC DENTAL PROFESSIONALS LLC
PEDIATRIC DENTAL PROFESSIONALS LLC
NPI: 1730544743
· LYNN, MA 01901
· Pediatric Dentist
· NPI assigned 12/17/2015
$238K
Total Medicaid Paid
Provider Details
| Authorized Official | JAVEDAN, PEDRAM (DENTIST) |
| NPI Enumeration Date | 12/17/2015 |
Related Entities
Other providers sharing the same authorized official: JAVEDAN, PEDRAM
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,246 |
$45K |
| 2019 |
1,450 |
$53K |
| 2020 |
1,504 |
$55K |
| 2021 |
2,425 |
$86K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
1,854 |
1,837 |
$91K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,992 |
1,971 |
$56K |
| D0120 |
Periodic oral evaluation - established patient |
1,580 |
1,566 |
$44K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
364 |
352 |
$18K |
| D0272 |
Bitewings - two radiographic images |
375 |
366 |
$11K |
| D1110 |
Prophylaxis - adult |
161 |
153 |
$8K |
| D1351 |
Sealant - per tooth |
139 |
33 |
$5K |
| D0274 |
Bitewings - four radiographic images |
57 |
57 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
75 |
75 |
$1K |
| D0140 |
Limited oral evaluation - problem focused |
28 |
28 |
$1K |