PEDIATRIC DENTAL ASSOC P.C.
NPI: 1851329510
· MANCHESTER, CT 06042
· Pediatric Dentist
· NPI assigned 06/29/2006
$703K
Total Medicaid Paid
Provider Details
| Authorized Official | PERKINS, EILEEN (OFFICE MANAGER) |
| NPI Enumeration Date | 06/29/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
3,635 |
$106K |
| 2019 |
3,684 |
$111K |
| 2020 |
2,391 |
$74K |
| 2021 |
3,204 |
$97K |
| 2022 |
3,747 |
$109K |
| 2023 |
3,587 |
$109K |
| 2024 |
3,155 |
$98K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
7,114 |
6,849 |
$279K |
| D0120 |
Periodic oral evaluation - established patient |
7,725 |
7,330 |
$215K |
| D1208 |
Topical application of fluoride, excluding varnish |
7,841 |
7,442 |
$181K |
| D8670 |
Periodic orthodontic treatment visit |
193 |
193 |
$15K |
| D0272 |
Bitewings - two radiographic images |
325 |
314 |
$8K |
| D0274 |
Bitewings - four radiographic images |
70 |
69 |
$3K |
| D1351 |
Sealant - per tooth |
34 |
13 |
$1K |
| D1110 |
Prophylaxis - adult |
101 |
89 |
$798.72 |