Dental
Manhattan Boulevard Dental Associates, a Professional Corporation
Manhattan Boulevard Dental Associates, a Professional Corporation was paid $56K by Medicaid between Jan 2018 and Aug 2021, across 16 billing codes. Its largest line is D1110, Prophylaxis - adult — 22% of everything it billed.
33Billing provider infoMANHATTAN BOULEVARD DENTAL ASSOCIATES, A PROFESSIONAL CORPORATION
MARIETTA, GA 30067
MARIETTA, GA 30067
33aNPI1750750360assigned 09/24/2015
33bProvider typeDentist
28Total paid$56K
24GClaims9,642
24DCodes billed16
24AFirst – last monthJan 2018 – Aug 2021
Compared with peers
Next to other Dentist providers in Georgia
Rank by total paid#30 of 55
Median peer was paid$64K
This provider vs. median0.9×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 8,086 | $36K | |
| 2019 | 635 | $0.00 | |
| 2020 | 291 | $4K | |
| 2021 | 630 | $17K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 22% | 1,303 | 558 | $12K |
| D0210 | Intraoral - complete series of radiographic images | 21% | 343 | 280 | $12K |
| D0150 | Comprehensive oral evaluation - new or established patient | 21% | 896 | 383 | $11K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 15% | 827 | 125 | $8K |
| D0140 | Limited oral evaluation - problem focused | 4.9% | 187 | 97 | $3K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 4.4% | 1,766 | 572 | $2K |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 3.9% | 23 | 12 | $2K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 3.5% | 162 | 28 | $2K |
| D0220 | Intraoral - periapical first radiographic image | 2.9% | 429 | 231 | $2K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 1.3% | 81 | 13 | $702.02 |
| D0274 | Bitewings - four radiographic images | <1% | 12 | 12 | $308.70 |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 21 | 15 | $73.38 |
4 more codes
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialCOSSICH, DIMETRY (PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| Todays Dental Covington LLC | Covington, LA | $1.99M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.