STURBRIDGE CHILDREN DENTISTRY
NPI: 1770752974
· STURBRIDGE, MA 01566
· Pediatric Dentist
· NPI assigned 02/21/2008
$144K
Total Medicaid Paid
Provider Details
| Authorized Official | RESTREPO, OLGA (PEDIATRIC DENTIST) |
| NPI Enumeration Date | 02/21/2008 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,312 |
$36K |
| 2019 |
1,038 |
$28K |
| 2020 |
552 |
$15K |
| 2021 |
720 |
$20K |
| 2022 |
712 |
$20K |
| 2023 |
600 |
$16K |
| 2024 |
301 |
$9K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
1,958 |
1,885 |
$43K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,847 |
1,774 |
$42K |
| D1120 |
Prophylaxis - child |
868 |
828 |
$32K |
| D1110 |
Prophylaxis - adult |
530 |
509 |
$27K |
| D0272 |
Bitewings - two radiographic images |
17 |
15 |
$420.00 |
| D1330 |
|
15 |
14 |
$0.00 |