EDEN PRAIRIE ORTHODONTIC ASSOC
NPI: 1457969636
· EDEN PRAIRIE, MN 55344
· Orthodontics and Dentofacial Orthopedic Dentist
· NPI assigned 07/14/2020
$1.14M
Total Medicaid Paid
Provider Details
| Authorized Official | SCHULTZ, DIANE (OFFICE MANAGER) |
| NPI Enumeration Date | 07/14/2020 |
Related Entities
Other providers sharing the same authorized official: SCHULTZ, DIANE
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
24 |
$3K |
| 2021 |
377 |
$47K |
| 2022 |
1,647 |
$331K |
| 2023 |
2,429 |
$465K |
| 2024 |
1,665 |
$298K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D8080 |
Comprehensive orthodontic treatment of the adolescent dentition |
2,806 |
2,798 |
$610K |
| D8670 |
Periodic orthodontic treatment visit |
1,381 |
1,380 |
$259K |
| D8090 |
|
1,142 |
1,142 |
$213K |
| D0340 |
|
190 |
185 |
$20K |
| D0160 |
|
222 |
215 |
$12K |
| D0470 |
|
178 |
173 |
$12K |
| D0350 |
|
121 |
120 |
$10K |
| D0330 |
Panoramic radiographic image |
102 |
101 |
$7K |