Dental
Pediatric and Adolescent Dentistry
Pediatric and Adolescent Dentistry was paid $5.12M by Medicaid between Jan 2018 and Dec 2024, across 28 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 20% of everything it billed.
33Billing provider infoPEDIATRIC AND ADOLESCENT DENTISTRY
MANKATO, MN 56001
MANKATO, MN 56001
33aNPI1699747378assigned 02/06/2006
33bProvider typePediatric Dentist
28Total paid$5.12M
24GClaims100,952
24DCodes billed28
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Minnesota
Rank by total paid#5 of 49
Median peer was paid$94K
This provider vs. median55×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 20,153 | $260K | |
| 2019 | 18,872 | $1.11M | |
| 2020 | 16,394 | $942K | |
| 2021 | 16,472 | $1.09M | |
| 2022 | 12,675 | $860K | |
| 2023 | 8,983 | $495K | |
| 2024incomplete | 7,403 | $358K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 20% | 6,257 | 1,757 | $1.01M |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 12% | 15,660 | 15,288 | $610K |
| D1206 | Topical application of fluoride varnish | 12% | 19,379 | 18,969 | $601K |
| D1120 | Dental cleaning, childProphylaxis - child | 12% | 13,568 | 13,257 | $598K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 4.8% | 2,802 | 1,163 | $248K |
| D7140 | Extraction, erupted tooth or exposed root | 4.7% | 2,508 | 1,180 | $241K |
| D2150 | Silver amalgam - two surfaces, primary or permanent | 4.5% | 2,604 | 968 | $232K |
| D1110 | Prophylaxis - adult | 4.1% | 3,159 | 3,088 | $211K |
| D0272 | Bitewings - two radiographic images | 3.7% | 5,417 | 5,278 | $188K |
| D2934 | 3.6% | 724 | 227 | $186K | |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 2.4% | 5,614 | 5,279 | $123K |
| D1351 | Sealant - per tooth | 2.3% | 3,037 | 807 | $115K |
16 more codes
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 2.1% | 1,004 | $107K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 1.8% | 1,149 | $90K |
| D9310 | 1.7% | 1,414 | $88K | |
| D0240 | 1.6% | 4,108 | $80K | |
| D2140 | 1.3% | 845 | $65K | |
| D0230 | Intraoral - periapical each additional radiographic image | 1.1% | 3,809 | $54K |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.0% | 1,520 | $52K |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 1,041 | $47K |
| D0274 | Bitewings - four radiographic images | <1% | 1,055 | $44K |
| D0220 | Intraoral - periapical first radiographic image | <1% | 2,057 | $41K |
| D9420 | <1% | 1,308 | $40K | |
| D2330 | <1% | 168 | $17K | |
| D0140 | Limited oral evaluation - problem focused | <1% | 342 | $14K |
| D0330 | Panoramic radiographic image | <1% | 162 | $10K |
| D2933 | <1% | 229 | $7K | |
| D9995 | 0% | 12 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialWALTON, JAMES (OWNER)