Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › MN › BLAINE › CAMPODONICO FAMILY & COSMETIC DENTISTRY PC

CAMPODONICO FAMILY & COSMETIC DENTISTRY PC

NPI: 1104249259 · BLAINE, MN 55449 · General Practice Dentistry · NPI assigned 01/27/2014

$7K
Total Medicaid Paid
307
Total Claims
299
Beneficiaries
7
Codes Billed
2019-01
First Month
2024-10
Last Month

Provider Details

Authorized OfficialCAMPODONICO, CARLOS (OWNER)
NPI Enumeration Date01/27/2014

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2019 186 $5K
2020 71 $311.40
2022 26 $987.75
2024 24 $678.83

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0120 Periodic oral evaluation - established patient 63 63 $2K
D0274 Bitewings - four radiographic images 43 42 $1K
D1206 Topical application of fluoride varnish 73 72 $1K
D1110 Prophylaxis - adult 31 30 $1K
D0330 Panoramic radiographic image 14 14 $635.76
D0150 Comprehensive oral evaluation - new or established patient 26 26 $632.60
D1999 57 52 $0.00