Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › MN › PELICAN RAPIDS › LAKELAND SMILES, PLLC

LAKELAND SMILES, PLLC

NPI: 1467807412 · PELICAN RAPIDS, MN 56572 · Dental Clinic/Center · NPI assigned 04/27/2016

$2K
Total Medicaid Paid
50
Total Claims
50
Beneficiaries
3
Codes Billed
2022-10
First Month
2024-04
Last Month

Provider Details

Authorized OfficialBAILLARGEON, BETHANY (DENTIST)
NPI Enumeration Date04/27/2016

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2022 25 $1K
2024 25 $795.93

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0120 Periodic oral evaluation - established patient 24 24 $894.46
D1110 Prophylaxis - adult 13 13 $750.88
D1206 Topical application of fluoride varnish 13 13 $335.39