RHODE ISLAND CHILDREN'S DENTISTRY
NPI: 1922548015
· SUTTON, MA 01590
· Pediatric Dentist
· NPI assigned 03/08/2017
$161K
Total Medicaid Paid
Provider Details
| Authorized Official | HORNE, REBECCA (MANAGER) |
| Parent Organization | RHODE ISLAND CHILDRENS DENTISTRY |
| NPI Enumeration Date | 03/08/2017 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
795 |
$27K |
| 2019 |
1,033 |
$34K |
| 2020 |
1,753 |
$60K |
| 2021 |
1,176 |
$40K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
1,582 |
1,533 |
$72K |
| D1206 |
Topical application of fluoride varnish |
1,640 |
1,583 |
$40K |
| D0120 |
Periodic oral evaluation - established patient |
970 |
950 |
$27K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
218 |
201 |
$12K |
| D0272 |
Bitewings - two radiographic images |
238 |
234 |
$7K |
| D1351 |
Sealant - per tooth |
54 |
13 |
$2K |
| D0140 |
Limited oral evaluation - problem focused |
16 |
15 |
$784.00 |
| D0240 |
|
27 |
25 |
$390.00 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
12 |
12 |
$252.00 |