CHASKA FAMILY DENTAL, P.L.L.C.
NPI: 1740969518
· CHASKA, MN 55318
· Dental Clinic/Center
· NPI assigned 07/17/2023
$257K
Total Medicaid Paid
Provider Details
| Authorized Official | MANN, COURTNEY (CEO) |
| NPI Enumeration Date | 07/17/2023 |
Related Entities
Other providers sharing the same authorized official: MANN, COURTNEY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
1,571 |
$59K |
| 2024 |
3,282 |
$198K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D2722 |
|
55 |
41 |
$59K |
| D1110 |
Prophylaxis - adult |
667 |
667 |
$45K |
| D0120 |
Periodic oral evaluation - established patient |
1,094 |
1,094 |
$44K |
| D1120 |
Prophylaxis - child |
454 |
454 |
$21K |
| D0274 |
Bitewings - four radiographic images |
446 |
446 |
$20K |
| D1206 |
Topical application of fluoride varnish |
554 |
554 |
$19K |
| D1330 |
|
252 |
252 |
$10K |
| D0330 |
Panoramic radiographic image |
103 |
103 |
$8K |
| D2950 |
|
34 |
25 |
$7K |
| D0230 |
Intraoral - periapical each additional radiographic image |
526 |
190 |
$6K |
| D0220 |
Intraoral - periapical first radiographic image |
368 |
364 |
$6K |
| D0140 |
Limited oral evaluation - problem focused |
125 |
122 |
$5K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
87 |
87 |
$4K |
| D0272 |
Bitewings - two radiographic images |
88 |
88 |
$3K |