GREAT LAKES CHILDRENS DENTAL CARE PA
NPI: 1790795821
· DULUTH, MN 55811
· 1223P0221X
$785K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
2,015 |
$59K |
| 2019 |
1,553 |
$69K |
| 2020 |
969 |
$43K |
| 2021 |
2,601 |
$144K |
| 2022 |
2,576 |
$148K |
| 2023 |
3,494 |
$229K |
| 2024 |
1,514 |
$93K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D2391 |
|
1,494 |
522 |
$187K |
| D0120 |
|
2,439 |
2,348 |
$117K |
| D1206 |
|
2,687 |
2,544 |
$89K |
| D1120 |
|
1,688 |
1,603 |
$88K |
| D9230 |
|
1,193 |
1,115 |
$57K |
| D1110 |
|
747 |
707 |
$55K |
| D2392 |
|
275 |
154 |
$45K |
| D0272 |
|
886 |
846 |
$31K |
| D0220 |
|
1,047 |
998 |
$23K |
| D0230 |
|
933 |
455 |
$19K |
| D0274 |
|
387 |
373 |
$18K |
| D0330 |
|
189 |
161 |
$15K |
| D1310 |
|
206 |
206 |
$11K |
| D1330 |
|
262 |
262 |
$11K |
| D1351 |
|
205 |
44 |
$8K |
| D2930 |
|
29 |
13 |
$6K |
| D7140 |
|
17 |
15 |
$2K |
| D0150 |
|
38 |
37 |
$2K |