WAYZATA DENTAL, LTD.
NPI: 1659554517
· WAYZATA, MN 55391
· General Practice Dentistry
· NPI assigned 12/13/2007
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
13 |
$630.12 |
| 2024 |
276 |
$19K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
153 |
15 |
$13K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
52 |
14 |
$3K |
| D1110 |
Prophylaxis - adult |
30 |
29 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
25 |
25 |
$940.27 |
| D0274 |
Bitewings - four radiographic images |
17 |
17 |
$578.76 |
| D1206 |
Topical application of fluoride varnish |
12 |
12 |
$304.92 |