NPI: 1811033061 · WILLMAR, MN 56201 · Public Health Dentist · NPI assigned 01/29/2007
| Authorized Official | GLANCEY, LYNN (CHIEF FINANCIAL OFFICER) |
| NPI Enumeration Date | 01/29/2007 |
Other providers sharing the same authorized official: GLANCEY, LYNN
| Provider | City | State | Total Paid |
|---|---|---|---|
| MINNESOTA SPECIALTY HEALTH SYSTEMS-WADENA | WADENA | MN | $6.65M |
| MINNESOTA SPECIALTY HEALTH SYSTEMS-BRAINERD | BRAINERD | MN | $6.25M |
| MINNESOTA SPECIALITY HEALTH SYSTEMS WILLMAR | WILLMAR | MN | $5.56M |
| COMMUNITY ADDICTION RECOVERY ENTERPRISE FERGUS FALLS | FERGUS FALLS | MN | $4.56M |
| COMMUNITY ADDICTION RECOVERY ENTERPRISE ANOKA | ANOKA | MN | $2.67M |
| COMMUNITY ADDICTION RECOVERY ENTERPRISE CARLTON | CARLTON | MN | $2.16M |
| SPECIAL CARE DENTISTRY FERGUS FALLS | FERGUS FALLS | MN | $382K |
| CENTRAL LAKES COMMUNITY DENTAL CLINIC | BRAINERD | MN | $306K |
| HEALTH SOURCE DENTAL CLINIC | CAMBRIDGE | MN | $286K |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 1,958 | $26K |
| 2019 | 3,730 | $50K |
| 2020 | 3,097 | $47K |
| 2021 | 4,312 | $58K |
| 2022 | 6,589 | $67K |
| 2023 | 6,557 | $71K |
| 2024 | 4,671 | $64K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 6,942 | 6,712 | $163K |
| D7140 | Extraction, erupted tooth or exposed root | 1,197 | 618 | $47K |
| D1206 | Topical application of fluoride varnish | 4,682 | 4,071 | $47K |
| D0120 | Periodic oral evaluation - established patient | 4,456 | 3,935 | $41K |
| D0274 | Bitewings - four radiographic images | 1,872 | 1,666 | $22K |
| D0230 | Intraoral - periapical each additional radiographic image | 6,619 | 2,068 | $20K |
| D0140 | Limited oral evaluation - problem focused | 1,204 | 1,086 | $19K |
| D0220 | Intraoral - periapical first radiographic image | 3,499 | 2,890 | $16K |
| D1354 | 297 | 171 | $3K | |
| D9920 | 99 | 85 | $2K | |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 28 | 15 | $974.97 |
| D2940 | 19 | 13 | $428.76 |