HYANNIS HARBOR DENTAL, PC
NPI: 1891850996
· HYANNIS, MA 02601
· General Practice Dentistry
· NPI assigned 12/27/2006
$101K
Total Medicaid Paid
Provider Details
| Authorized Official | EGAN, EDWARD (OWNER) |
| NPI Enumeration Date | 12/27/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
644 |
$24K |
| 2020 |
1,020 |
$39K |
| 2021 |
998 |
$37K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
694 |
690 |
$46K |
| D0120 |
Periodic oral evaluation - established patient |
975 |
962 |
$26K |
| D1206 |
Topical application of fluoride varnish |
831 |
817 |
$21K |
| D0274 |
Bitewings - four radiographic images |
130 |
128 |
$5K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
19 |
12 |
$2K |
| D1120 |
Prophylaxis - child |
13 |
13 |
$663.00 |