Clinic
Nicollet Family Dentistry
Nicollet Family Dentistry was paid $70K by Medicaid between Sep 2022 and Sep 2024, across 8 billing codes. Its largest line is D5110, — 41% of everything it billed.
33Billing provider infoNICOLLET FAMILY DENTISTRY
NEW HOPE, MN 55427
NEW HOPE, MN 55427
33aNPI1841915741assigned 10/04/2022
33bProvider typeDental Clinic/Center
28Total paid$70K
24GClaims1,206
24DCodes billed8
24AFirst – last monthSep 2022 – Sep 2024
Compared with peers
Next to other Dental Clinic/Center providers in Minnesota
Rank by total paid#75 of 148
Median peer was paid$70K
This provider vs. median1.0×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2022 | 142 | $3K | |
| 2023 | 711 | $44K | |
| 2024incomplete | 353 | $22K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D5110 | 41% | 30 | 29 | $29K | |
| D0140 | Limited oral evaluation - problem focused | 18% | 389 | 346 | $13K |
| D5120 | 18% | 13 | 12 | $13K | |
| D0330 | Panoramic radiographic image | 9.3% | 133 | 130 | $7K |
| D7140 | Extraction, erupted tooth or exposed root | 4.9% | 35 | 13 | $3K |
| D0220 | Intraoral - periapical first radiographic image | 4.6% | 248 | 220 | $3K |
| D0230 | Intraoral - periapical each additional radiographic image | 3.4% | 339 | 129 | $2K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | <1% | 19 | 19 | $505.78 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialCHARLES, TRACEY (DOCTOR/OWNER)