ANDERSON FAMILY DENTAL PA
NPI: 1356697973
· COLERAINE, MN 55722
· General Practice Dentistry
· NPI assigned 08/01/2012
$333K
Total Medicaid Paid
Provider Details
Related Entities
Other providers sharing the same authorized official: ANDERSON, JORDAN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,770 |
$8K |
| 2019 |
1,234 |
$59K |
| 2020 |
812 |
$37K |
| 2021 |
737 |
$34K |
| 2022 |
1,296 |
$58K |
| 2023 |
1,897 |
$81K |
| 2024 |
1,433 |
$57K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
2,977 |
2,949 |
$97K |
| D1110 |
Prophylaxis - adult |
1,408 |
1,394 |
$89K |
| D1206 |
Topical application of fluoride varnish |
2,670 |
2,644 |
$60K |
| D1120 |
Prophylaxis - child |
1,305 |
1,294 |
$57K |
| D0274 |
Bitewings - four radiographic images |
404 |
399 |
$16K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
150 |
68 |
$7K |
| D0330 |
Panoramic radiographic image |
84 |
83 |
$4K |
| D0272 |
Bitewings - two radiographic images |
151 |
148 |
$3K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
30 |
13 |
$0.00 |