METROPOLITAN PEDIATRIC DENTAL ASSOCIATES, LTD
NPI: 1083763023
· NORTH OAKS, MN 55127
· Pediatric Dentist
· NPI assigned 01/09/2007
$315K
Total Medicaid Paid
Provider Details
| Authorized Official | NICKMAN, JAMES (PRESIDENT) |
| Parent Organization | METROPOLITAN PEDIATRIC DENTAL ASSOCIATES, LTD |
| NPI Enumeration Date | 01/09/2007 |
Related Entities
Other providers sharing the same authorized official: NICKMAN, JAMES
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
2,822 |
$11K |
| 2019 |
2,754 |
$58K |
| 2020 |
1,281 |
$26K |
| 2021 |
2,301 |
$49K |
| 2022 |
1,590 |
$59K |
| 2023 |
1,565 |
$55K |
| 2024 |
1,575 |
$56K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
4,350 |
4,317 |
$114K |
| D1206 |
Topical application of fluoride varnish |
3,816 |
3,792 |
$79K |
| D1120 |
Prophylaxis - child |
2,437 |
2,414 |
$58K |
| D1110 |
Prophylaxis - adult |
819 |
816 |
$30K |
| D0272 |
Bitewings - two radiographic images |
1,370 |
1,355 |
$25K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
710 |
645 |
$7K |
| D0274 |
Bitewings - four radiographic images |
69 |
68 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
28 |
28 |
$209.60 |
| D1208 |
Topical application of fluoride, excluding varnish |
260 |
254 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
16 |
16 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
13 |
13 |
$0.00 |