MINNETONKA DENTAL, P.L.L.C
NPI: 1477233955
· MINNETONKA, MN 55345
· Dental Clinic/Center
· NPI assigned 07/20/2023
Provider Details
| Authorized Official | MANN, COURTNEY (CEO) |
| NPI Enumeration Date | 07/20/2023 |
Related Entities
Other providers sharing the same authorized official: MANN, COURTNEY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
307 |
$13K |
| 2024 |
1,726 |
$86K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
430 |
428 |
$25K |
| D2722 |
|
23 |
12 |
$20K |
| D0120 |
Periodic oral evaluation - established patient |
479 |
478 |
$16K |
| D0274 |
Bitewings - four radiographic images |
284 |
284 |
$11K |
| D0330 |
Panoramic radiographic image |
90 |
90 |
$6K |
| D1206 |
Topical application of fluoride varnish |
170 |
170 |
$5K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
102 |
102 |
$4K |
| D1120 |
Prophylaxis - child |
74 |
74 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
179 |
171 |
$3K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
24 |
12 |
$2K |
| D0230 |
Intraoral - periapical each additional radiographic image |
164 |
103 |
$2K |
| D1330 |
|
14 |
14 |
$474.60 |