ST. CROIX KIDDS PEDIATRIC DENTISTRY
NPI: 1407131618
· WHITE BEAR LAKE, MN 55110
· Pediatric Dentist
· NPI assigned 10/19/2011
$122K
Total Medicaid Paid
Provider Details
| Authorized Official | RINDELAUB, DARCY (PEDIATRIC DENTIST) |
| NPI Enumeration Date | 10/19/2011 |
Related Entities
Other providers sharing the same authorized official: RINDELAUB, DARCY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
378 |
$0.00 |
| 2023 |
2,013 |
$39K |
| 2024 |
3,726 |
$83K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
1,778 |
1,653 |
$46K |
| D0120 |
Periodic oral evaluation - established patient |
1,739 |
1,615 |
$33K |
| D1206 |
Topical application of fluoride varnish |
1,637 |
1,513 |
$24K |
| D0272 |
Bitewings - two radiographic images |
559 |
525 |
$9K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
245 |
198 |
$7K |
| D1351 |
Sealant - per tooth |
92 |
26 |
$2K |
| D0330 |
Panoramic radiographic image |
22 |
14 |
$736.75 |
| D0220 |
Intraoral - periapical first radiographic image |
45 |
41 |
$161.56 |