Dental
Pokegama Dental
Pokegama Dental was paid $216K by Medicaid between Sep 2023 and Dec 2024, across 14 billing codes. Its largest line is D1110, Prophylaxis - adult — 15% of everything it billed.
33Billing provider infoPOKEGAMA DENTAL
GRAND RAPIDS, MN 55744
GRAND RAPIDS, MN 55744
33aNPI1215614532assigned 06/28/2023
33bProvider typeGeneral Practice Dentistry
28Total paid$216K
24GClaims4,255
24DCodes billed14
24AFirst – last monthSep 2023 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in Minnesota
Rank by total paid#96 of 368
Median peer was paid$19K
This provider vs. median11×
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 | |
|---|---|---|---|
| 2023 | 1,123 | $54K | |
| 2024incomplete | 3,132 | $162K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 15% | 407 | 403 | $33K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 14% | 702 | 696 | $29K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 13% | 223 | 125 | $29K |
| D1120 | Dental cleaning, childProphylaxis - child | 11% | 383 | 380 | $23K |
| D1206 | Topical application of fluoride varnish | 10% | 765 | 760 | $22K |
| D0330 | Panoramic radiographic image | 8.5% | 226 | 225 | $18K |
| D0274 | Bitewings - four radiographic images | 7.3% | 311 | 307 | $16K |
| D0140 | Limited oral evaluation - problem focused | 5.2% | 274 | 264 | $11K |
| D1330 | 4.9% | 403 | 403 | $11K | |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 4.9% | 65 | 44 | $10K |
| D9986 | 2.5% | 278 | 253 | $5K | |
| D2394 | 1.3% | 14 | 12 | $3K |
2 more codes
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 officialSCHMITT, TERRY (OWNER/DENTIST)