CLEAN AND SEAL DENTAL PROGRAM
NPI: 1821601170
· DORCHESTER, MA 02124
· Public Health or Welfare Agency
· NPI assigned 08/26/2020
$976K
Total Medicaid Paid
Provider Details
| Authorized Official | BROOKS, FAITH (PUBLIC HEALTH DENTAL HYGIENIST) |
| NPI Enumeration Date | 08/26/2020 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
1,845 |
$63K |
| 2022 |
6,974 |
$259K |
| 2023 |
9,356 |
$330K |
| 2024 |
9,814 |
$324K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1351 |
Sealant - per tooth |
9,807 |
2,645 |
$388K |
| D0190 |
|
7,118 |
7,051 |
$197K |
| D1206 |
Topical application of fluoride varnish |
6,925 |
6,885 |
$192K |
| D1120 |
Prophylaxis - child |
3,611 |
3,583 |
$187K |
| D9410 |
|
276 |
270 |
$7K |
| D1354 |
|
252 |
82 |
$4K |