Boylston Street Dental, LLC

Boylston Street Dental, LLC was paid $281K by Medicaid between Apr 2018 and Jul 2024, across 7 billing codes. Its largest line is D1120, dental cleaning, child — 34% of everything it billed.

33Billing provider infoBOYLSTON STREET DENTAL, LLC
CHESTNUT HILL, MA 02467

33aNPI1922513597assigned 12/05/2017

33bProvider typeDentist

28Total paid$281K

24GClaims9,185

24DCodes billed7

24AFirst – last monthApr 2018 – Jul 2024

Compared with peers

Next to other Dentist providers in Massachusetts

Rank by total paid#134 of 413

Median peer was paid$93K

This provider vs. median3.0×

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	1,100	$27K
2019	1,251	$40K
2020	912	$29K
2021	1,525	$48K
2022	1,904	$60K
2023	1,615	$49K
2024incomplete	878	$27K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1120	Dental cleaning, childProphylaxis - child	34%	2,036	1,986	$95K
D1206	Topical application of fluoride varnish	30%	3,576	3,475	$84K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	29%	3,158	3,068	$81K
D1110	Prophylaxis - adult	6.6%	333	322	$19K
D1351	Sealant - per tooth	<1%	43	13	$2K
D0272	Bitewings - two radiographic images	<1%	26	26	$672.00
D0274	Bitewings - four radiographic images	<1%	13	13	$598.00

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 officialPOLIVY, ADAM (PARTNER)