Clinic
Lake City Dental Clinic
Lake City Dental Clinic was paid $291.46 by Medicaid between Dec 2021 and Dec 2021, across 1 billing code. Its largest line is D0120, dental checkup, returning patient — 100% of everything it billed.
33Billing provider infoLAKE CITY DENTAL CLINIC
LAKE CITY, CO 81235
LAKE CITY, CO 81235
33aNPI1376143081assigned 10/30/2020
33bProvider typeDental Clinic/Center
28Total paid$291.46
24GClaims13
24DCodes billed1
24AFirst – last monthDec 2021 – Dec 2021
Compared with peers
Next to other Dental Clinic/Center providers in Colorado
Rank by total paid#193 of 193
Median peer was paid$180K
This provider vs. median0.0×
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 | |
|---|---|---|---|
| 2021 | 13 | $291.46 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 100% | 13 | 13 | $291.46 |
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 officialWHIDDON, JESSICA (EXECUTIVE DIRECTOR)