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    OpenPayerNPI Medicare & MedicaidPediatric And Adolescent Dentistry
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    Pediatric And Adolescent Dentistry — Billing Profile & Reimbursement Data

    NPI 1699747378 · Mankato, MN · Pediatric Dentistry

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    Pediatric And Adolescent Dentistry is a pediatric dentistry provider located in Mankato, Minnesota. This profile covers 0 Medicare and 28 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationPediatric And Adolescent Dentistry
    Address212 Star St
    CityMankato
    StateMN
    ZIP56001
    TaxonomyPediatric Dentistry
    NPI EnumeratedFebruary 6, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$5.1M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

    Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

    28 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    D2930N/A6,260$160$1M
    D0120Periodic oral evaluation - established patient15,660$40$610.7K
    D1206Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients19,380$30$600.7K
    D1120Prophylaxis–child13,570$40$597K
    D3220N/A2,800$90$246.6K
    D7140Extraction, erupted tooth or exposed root (elevation and/or forceps removal)2,510$100$240.8K
    D2150Amalgam - two surfaces, primary or permanent2,600$90$231.8K
    D1110Prophylaxis - adult; cleaning and polishing of the teeth3,160$70$211.7K
    D0272N/A5,420$40$189.6K
    D2934N/A720$260$185.3K

    Showing 1–10 of 28

    Medicaid: Competitive Analysis & Benchmarks

    How this provider's Medicaid billing volume and revenue compare to other Minnesota providers billing the same CPT/HCPCS codes.

    Full comparison — all codes billed, vs. Minnesota median

    28 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    D2930N/A1270610$170$518.6K
    D7140Extraction, erupted tooth or exposed root (elevation and/or forceps removal)58240730$100$243.2K
    D2392Post 2 surface resin‑based composite95270540$90$161.5K
    D0140Limited oral evaluation – problem focused248390730$60$153.3K
    D0120Periodic oral evaluation - established patient29740430$50$120.3K
    D2391Resin‑based composite – one surface, posterior83250420$70$116.6K
    D2934N/A310440$260$112.8K
    D0330N/A262370590$60$109K
    D0240N/A850510$30$95.5K
    D1110Prophylaxis - adult; cleaning and polishing of the teeth107640380$50$93.7K

    Showing 1–10 of 28

    Nearby Providers

    Other providers in the same ZIP code as Pediatric And Adolescent Dentistry, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Habilitative Services, LLCMNCommunity/Behavioral Health Agency$0$134M
    Mankato Clinic LtdMNFamily Medicine Physician$0$39.2M
    Mayo Clinic Health System-southwest Minnesota RegionMNGeneral Acute Care Hospital$0$28.5M
    Mayo Clinic Health System-southwest Minnesota RegionMNMulti-Specialty Clinic/Center$0$24.3M
    Open Door Health CenterMNFederally Qualified Health Center (FQHC)$0$13.5M
    County Of Blue EarthMNCase Management Agency$0$10.8M
    Horizon Homes, Inc.MNMental Illness Community Based Residential Treatment Facility$0$8.8M
    Ms-ac Mankato Ag Senior Living LLCMNAssisted Living Facility$0$8.3M
    Horizon Homes, Inc.MNMental Illness Community Based Residential Treatment Facility$0$6.2M
    Adult, Child & Family Services, LLCMNPsychologist$0$5.2M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Minnesota Providers
    0 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Minnesota Distribution
    Pediatric And Adolescent Dentistry — 4 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Minnesota