PEACHY SMILES ASHMONT LLC
NPI: 1831345834
· DORCHESTER CENTER, MA 02124
· General Practice Dentistry
· NPI assigned 08/11/2008
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
62 |
$2K |
| 2020 |
131 |
$5K |
| 2021 |
208 |
$8K |
| 2022 |
189 |
$4K |
| 2023 |
24 |
$868.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
222 |
208 |
$10K |
| D0120 |
Periodic oral evaluation - established patient |
126 |
122 |
$3K |
| D0274 |
Bitewings - four radiographic images |
58 |
54 |
$2K |
| D0210 |
Intraoral - complete series of radiographic images |
19 |
18 |
$1K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
28 |
27 |
$909.74 |
| D0220 |
Intraoral - periapical first radiographic image |
65 |
56 |
$781.00 |
| D1206 |
Topical application of fluoride varnish |
25 |
24 |
$548.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
57 |
37 |
$523.00 |
| D1120 |
Prophylaxis - child |
14 |
13 |
$514.00 |