Evergreen Dental LLC

Evergreen Dental LLC was paid $97K by Medicaid between Jan 2018 and Sep 2020, across 9 billing codes. Its largest line is D1110, Prophylaxis - adult — 48% of everything it billed.

33Billing provider infoEVERGREEN DENTAL LLC
BILLERICA, MA 01821

33aNPI1831513126assigned 02/07/2014

33bProvider typeDentist

28Total paid$97K

24GClaims2,797

24DCodes billed9

24AFirst – last monthJan 2018 – Sep 2020

Compared with peers

Next to other Dentist providers in Massachusetts

Rank by total paid#202 of 413

Median peer was paid$93K

This provider vs. median1.0×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2018	1,427	$51K
2019	991	$34K
2020	379	$12K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1110	Prophylaxis - adult	48%	903	901	$46K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	22%	945	945	$21K
D0274	Bitewings - four radiographic images	12%	344	344	$12K
D0150	Comprehensive oral evaluation - new or established patient	4.9%	119	118	$5K
D0210	Intraoral - complete series of radiographic images	4.7%	66	65	$5K
D1208	Topical application of fluoride, excluding varnish	4.5%	153	153	$4K
D0220	Intraoral - periapical first radiographic image	2.7%	179	178	$3K
D0140	Limited oral evaluation - problem focused	1.3%	33	33	$1K
D0230	Intraoral - periapical each additional radiographic image	<1%	55	40	$682.00

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.

From NPPES

Who's on the registration

Authorized officialHUH, JANGWON (PRESIDENT)