ADVANCED DENTISTRY INC.
NPI: 1760693972
· ST LOUIS PARK, MN 55416
· General Practice Dentistry
· NPI assigned 05/28/2007
$402K
Total Medicaid Paid
Provider Details
| Authorized Official | LYANSKY, RITA (CEO) |
| NPI Enumeration Date | 05/28/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
280 |
$5K |
| 2020 |
736 |
$13K |
| 2021 |
2,396 |
$44K |
| 2022 |
2,771 |
$85K |
| 2023 |
4,981 |
$172K |
| 2024 |
2,235 |
$82K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
2,043 |
2,027 |
$102K |
| D0330 |
Panoramic radiographic image |
927 |
912 |
$67K |
| D1206 |
Topical application of fluoride varnish |
2,067 |
2,047 |
$51K |
| D0140 |
Limited oral evaluation - problem focused |
1,449 |
1,323 |
$44K |
| D0120 |
Periodic oral evaluation - established patient |
1,525 |
1,514 |
$38K |
| D0274 |
Bitewings - four radiographic images |
829 |
823 |
$27K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
658 |
651 |
$24K |
| D0220 |
Intraoral - periapical first radiographic image |
1,574 |
1,529 |
$20K |
| D0230 |
Intraoral - periapical each additional radiographic image |
2,000 |
1,167 |
$17K |
| D9110 |
|
254 |
252 |
$10K |
| D1330 |
|
53 |
52 |
$2K |
| D1120 |
Prophylaxis - child |
20 |
19 |
$713.11 |