FAMILY & COSMETIC GENTLE DENTISTRY, LTD
NPI: 1295917755
· MINNEAPOLIS, MN 55417
· General Practice Dentistry
· NPI assigned 11/27/2007
$277K
Total Medicaid Paid
Provider Details
| Authorized Official | GAVIC, DIANA (OPERATIONS MANAGER) |
| Parent Organization | FAMILY & COSMETIC GENTLE DENTISTRY, LTD |
| NPI Enumeration Date | 11/27/2007 |
Related Entities
Other providers sharing the same authorized official: GAVIC, DIANA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,186 |
$3K |
| 2019 |
862 |
$32K |
| 2020 |
3,027 |
$120K |
| 2021 |
2,568 |
$99K |
| 2022 |
475 |
$23K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,604 |
1,514 |
$72K |
| D0330 |
Panoramic radiographic image |
516 |
450 |
$35K |
| D0274 |
Bitewings - four radiographic images |
1,105 |
1,014 |
$35K |
| D1206 |
Topical application of fluoride varnish |
1,465 |
1,396 |
$33K |
| D0120 |
Periodic oral evaluation - established patient |
1,281 |
1,239 |
$31K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
341 |
195 |
$27K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
589 |
520 |
$19K |
| D0140 |
Limited oral evaluation - problem focused |
331 |
291 |
$10K |
| D0220 |
Intraoral - periapical first radiographic image |
552 |
496 |
$7K |
| D1120 |
Prophylaxis - child |
96 |
96 |
$3K |
| D2160 |
|
15 |
12 |
$1K |
| D2140 |
|
18 |
13 |
$1K |
| D0272 |
Bitewings - two radiographic images |
29 |
29 |
$982.85 |
| D1330 |
|
17 |
17 |
$473.18 |
| D0230 |
Intraoral - periapical each additional radiographic image |
28 |
12 |
$223.67 |
| D1351 |
Sealant - per tooth |
131 |
17 |
$0.00 |