SOMERVILLE PEDIATRIC DENTISTRY PC
NPI: 1740061613
· SOMERVILLE, MA 02145
· Pediatric Dentist
· NPI assigned 10/09/2023
Provider Details
| Authorized Official | THACH, LEE (PEDIATRIC DENTIST) |
| NPI Enumeration Date | 10/09/2023 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
484 |
$21K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
148 |
148 |
$8K |
| D1208 |
Topical application of fluoride, excluding varnish |
225 |
225 |
$7K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
98 |
98 |
$6K |
| D0120 |
Periodic oral evaluation - established patient |
13 |
13 |
$403.00 |