NPI: 1467508226 · BRAINERD, MN 56401 · Public Health Dentist · NPI assigned 01/26/2007
| Authorized Official | GLANCEY, LYNN (CHIEF FINANCIAL OFFICER) |
| NPI Enumeration Date | 01/26/2007 |
Other providers sharing the same authorized official: GLANCEY, LYNN
| Provider | City | State | Total Paid |
|---|---|---|---|
| MINNESOTA SPECIALTY HEALTH SYSTEMS-WADENA | WADENA | MN | $6.65M |
| MINNESOTA SPECIALTY HEALTH SYSTEMS-BRAINERD | BRAINERD | MN | $6.25M |
| MINNESOTA SPECIALITY HEALTH SYSTEMS WILLMAR | WILLMAR | MN | $5.56M |
| COMMUNITY ADDICTION RECOVERY ENTERPRISE FERGUS FALLS | FERGUS FALLS | MN | $4.56M |
| COMMUNITY ADDICTION RECOVERY ENTERPRISE ANOKA | ANOKA | MN | $2.67M |
| COMMUNITY ADDICTION RECOVERY ENTERPRISE CARLTON | CARLTON | MN | $2.16M |
| SPECIAL CARE DENTISTRY FERGUS FALLS | FERGUS FALLS | MN | $382K |
| WILLMAR DENTAL CLINIC | WILLMAR | MN | $382K |
| HEALTH SOURCE DENTAL CLINIC | CAMBRIDGE | MN | $286K |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 3,324 | $25K |
| 2019 | 3,361 | $50K |
| 2020 | 2,114 | $34K |
| 2021 | 3,343 | $47K |
| 2022 | 4,051 | $50K |
| 2023 | 5,105 | $61K |
| 2024 | 2,784 | $39K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 6,290 | 5,995 | $139K |
| D9920 | 1,788 | 1,478 | $35K | |
| D0120 | Periodic oral evaluation - established patient | 3,595 | 3,209 | $34K |
| D0274 | Bitewings - four radiographic images | 2,317 | 2,046 | $28K |
| D1206 | Topical application of fluoride varnish | 2,588 | 2,262 | $25K |
| D0140 | Limited oral evaluation - problem focused | 1,110 | 1,047 | $16K |
| D0220 | Intraoral - periapical first radiographic image | 2,694 | 2,390 | $13K |
| D0230 | Intraoral - periapical each additional radiographic image | 3,507 | 1,209 | $11K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 47 | 38 | $2K |
| D2150 | Silver amalgam - two surfaces, primary or permanent | 37 | 28 | $2K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 27 | 24 | $828.03 |
| D1120 | Prophylaxis - child | 49 | 49 | $635.38 |
| D2331 | 12 | 12 | $498.30 | |
| D0190 | 21 | 20 | $0.00 |