NPI: 1508962994 · CAMBRIDGE, MN 55008 · Public Health Dentist · NPI assigned 09/15/2006
| Authorized Official | GLANCEY, LYNN (CHIEF FINANCIAL OFFICER) |
| NPI Enumeration Date | 09/15/2006 |
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 |
| CENTRAL LAKES COMMUNITY DENTAL CLINIC | BRAINERD | MN | $306K |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 4,202 | $42K |
| 2019 | 4,567 | $65K |
| 2020 | 2,615 | $37K |
| 2021 | 3,251 | $42K |
| 2022 | 2,771 | $37K |
| 2023 | 1,741 | $25K |
| 2024 | 2,754 | $38K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 6,022 | 5,823 | $135K |
| D1206 | Topical application of fluoride varnish | 2,990 | 2,739 | $34K |
| D0120 | Periodic oral evaluation - established patient | 3,483 | 3,268 | $31K |
| D9920 | 1,156 | 1,008 | $26K | |
| D0274 | Bitewings - four radiographic images | 1,368 | 1,252 | $19K |
| D0220 | Intraoral - periapical first radiographic image | 2,482 | 2,282 | $13K |
| D0230 | Intraoral - periapical each additional radiographic image | 3,513 | 1,683 | $12K |
| D0140 | Limited oral evaluation - problem focused | 734 | 699 | $11K |
| D0330 | Panoramic radiographic image | 57 | 50 | $2K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 32 | 25 | $1K |
| D2330 | 19 | 13 | $706.48 | |
| D2331 | 14 | 12 | $697.62 | |
| D2150 | Silver amalgam - two surfaces, primary or permanent | 14 | 13 | $593.46 |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 17 | 12 | $497.25 |