Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › MN › ROCHESTER › ROCHESTER PEDIATRIC DENTISTRY LLC

ROCHESTER PEDIATRIC DENTISTRY LLC

NPI: 1609272822 · ROCHESTER, MN 55904 · Pediatric Dentist · NPI assigned 11/16/2014

$11.64M
Total Medicaid Paid
202,076
Total Claims
153,618
Beneficiaries
31
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialJONES, KELLY (PEDIATRIC DENTIST, OWNER)
NPI Enumeration Date11/16/2014

Related Entities

Other providers sharing the same authorized official: JONES, KELLY

ProviderCityStateTotal Paid
MALBIS PARKWAY PEDIATRIC DENTISTRY DAPHNE AL $2.19M
SHERMAN OAKS MENTAL HEALTH GROUP GP SHERMAN OAKS CA $28K
CENTER FOR EMOTIONAL WELLNESS, PC DECATUR TX $349.56

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 22,423 $205K
2019 28,694 $1.49M
2020 22,868 $1.24M
2021 30,766 $1.73M
2022 32,527 $2.45M
2023 31,626 $2.26M
2024 33,172 $2.26M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D2930 Prefabricated stainless steel crown - primary tooth 17,917 5,872 $3.46M
D1120 Prophylaxis - child 24,071 23,931 $1.07M
D0120 Periodic oral evaluation - established patient 20,663 20,556 $838K
D1354 22,016 7,939 $792K
D1206 Topical application of fluoride varnish 23,980 23,808 $752K
D7140 Extraction, erupted tooth or exposed root 6,100 3,334 $664K
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 6,187 3,689 $584K
D1351 Sealant - per tooth 11,479 4,124 $461K
D0272 Bitewings - two radiographic images 13,031 12,938 $448K
D2391 Resin-based composite - one surface, posterior, primary or permanent 4,838 3,254 $372K
D0150 Comprehensive oral evaluation - new or established patient 6,050 6,014 $305K
D0330 Panoramic radiographic image 2,798 2,786 $275K
D9230 Inhalation of nitrous oxide / analgesia, anxiolysis 11,787 10,509 $265K
D2934 1,038 325 $262K
D0220 Intraoral - periapical first radiographic image 8,334 8,165 $186K
D3220 Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction 1,962 1,163 $178K
D0230 Intraoral - periapical each additional radiographic image 8,808 4,927 $153K
D0140 Limited oral evaluation - problem focused 2,295 2,244 $121K
D1330 2,621 2,608 $107K
D1110 Prophylaxis - adult 1,289 1,285 $77K
D1510 282 214 $59K
D9920 1,125 1,019 $58K
D0274 Bitewings - four radiographic images 777 777 $42K
D9420 1,002 950 $42K
D2330 378 270 $30K
D0170 267 262 $17K
D2331 163 113 $8K
D0145 Oral evaluation for a patient under three years of age 211 211 $5K
D2393 Resin-based composite - three surfaces, posterior, primary or permanent 37 31 $4K
D1353 556 286 $141.35
D1208 Topical application of fluoride, excluding varnish 14 14 $0.00