WAVERLEY DENTAL CARE
NPI: 1831230192
· BELMONT, MA 02478
· General Practice Dentistry
· NPI assigned 02/09/2007
$110K
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,161 |
$41K |
| 2019 |
924 |
$30K |
| 2020 |
536 |
$18K |
| 2021 |
604 |
$20K |
| 2022 |
31 |
$1K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,316 |
1,272 |
$63K |
| D0120 |
Periodic oral evaluation - established patient |
1,366 |
1,310 |
$28K |
| D0274 |
Bitewings - four radiographic images |
558 |
547 |
$18K |
| D1208 |
Topical application of fluoride, excluding varnish |
16 |
15 |
$435.00 |