Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › MN › EAGAN › MODERN DENTAL PROFESSIONALS, MN PC

MODERN DENTAL PROFESSIONALS, MN PC

NPI: 1710357520 · EAGAN, MN 55122 · General Practice Dentistry · NPI assigned 10/06/2015

$5K
Total Medicaid Paid
972
Total Claims
972
Beneficiaries
7
Codes Billed
2018-07
First Month
2018-12
Last Month

Provider Details

Authorized OfficialMOOS, JEFFREY (OWNER)
NPI Enumeration Date10/06/2015

Related Entities

Other providers sharing the same authorized official: MOOS, JEFFREY

ProviderCityStateTotal Paid
MERIT DENTAL MICHIGAN PC PORTAGE MI $161K
MODERN DENTAL PROFESSIONALS MINNESOTA PC WELLS MN $45K
MERIT DENTAL OF CONNECTICUT PC MONDOVI WI $16K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 972 $5K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1110 Prophylaxis - adult 219 219 $2K
D0120 Periodic oral evaluation - established patient 274 274 $1K
D0274 Bitewings - four radiographic images 147 147 $834.80
D1206 Topical application of fluoride varnish 215 215 $689.37
D1120 Prophylaxis - child 85 85 $501.95
D0220 Intraoral - periapical first radiographic image 20 20 $13.10
D0140 Limited oral evaluation - problem focused 12 12 $0.00