FREDERICK COMMUNITY DENTAL LLC
NPI: 1992110167
· FREDERICK, MD 21703
· Dentist
· NPI assigned 06/26/2014
$345K
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,594 |
$55K |
| 2019 |
1,727 |
$57K |
| 2020 |
1,073 |
$36K |
| 2021 |
1,298 |
$43K |
| 2022 |
1,646 |
$54K |
| 2023 |
1,683 |
$59K |
| 2024 |
1,150 |
$41K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
2,147 |
2,109 |
$94K |
| D1208 |
Topical application of fluoride, excluding varnish |
3,224 |
3,167 |
$74K |
| D0120 |
Periodic oral evaluation - established patient |
2,389 |
2,352 |
$71K |
| D1110 |
Prophylaxis - adult |
743 |
727 |
$43K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
585 |
568 |
$30K |
| D0330 |
Panoramic radiographic image |
427 |
417 |
$18K |
| D1351 |
Sealant - per tooth |
284 |
30 |
$8K |
| D0274 |
Bitewings - four radiographic images |
330 |
321 |
$7K |
| D0272 |
Bitewings - two radiographic images |
30 |
29 |
$450.00 |
| D0220 |
Intraoral - periapical first radiographic image |
12 |
12 |
$108.00 |