BOSTON FAMILY DENTAL LLC
NPI: 1801962618
· MALDEN, MA 02148
· Periodontist
· NPI assigned 11/27/2006
$478K
Total Medicaid Paid
Provider Details
| Authorized Official | LEE, TED (PRACTICE MANAGER) |
| NPI Enumeration Date | 11/27/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
2,991 |
$86K |
| 2019 |
389 |
$13K |
| 2020 |
1,874 |
$57K |
| 2021 |
2,856 |
$91K |
| 2022 |
2,328 |
$79K |
| 2023 |
2,585 |
$84K |
| 2024 |
2,033 |
$69K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
4,339 |
4,192 |
$219K |
| D0120 |
Periodic oral evaluation - established patient |
5,452 |
5,295 |
$121K |
| D0274 |
Bitewings - four radiographic images |
2,063 |
2,005 |
$70K |
| D0220 |
Intraoral - periapical first radiographic image |
1,571 |
1,524 |
$23K |
| D1120 |
Prophylaxis - child |
403 |
402 |
$20K |
| D1208 |
Topical application of fluoride, excluding varnish |
423 |
421 |
$12K |
| D0230 |
Intraoral - periapical each additional radiographic image |
741 |
673 |
$10K |
| D2140 |
|
23 |
15 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
27 |
27 |
$1K |
| D9110 |
|
14 |
14 |
$464.00 |