Michael T. Pederson, DDS

Michael T. Pederson, DDS was paid $9K by Medicaid between Jan 2018 and Sep 2022, across 5 billing codes. Its largest line is D0120, dental checkup, returning patient — 64% of everything it billed.

33Billing provider infoMICHAEL T. PEDERSON, DDS
WALKER, MN 56484

33aNPI1487675005assigned 07/21/2006

33bProvider typeGeneral Practice Dentistry

28Total paid$9K

24GClaims590

24DCodes billed5

24AFirst – last monthJan 2018 – Sep 2022

Compared with peers

Next to other General Practice Dentistry providers in Minnesota

Rank by total paid#218 of 368

Median peer was paid$19K

This provider vs. median0.5×

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
2018	112	$0.00
2019	16	$356.92
2020	201	$3K
2021	160	$2K
2022	101	$4K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	64%	258	257	$6K
D1110	Prophylaxis - adult	18%	51	51	$2K
D1206	Topical application of fluoride varnish	13%	108	108	$1K
D0274	Bitewings - four radiographic images	4.6%	13	13	$399.85
D9985		0%	160	139	$0.00

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 officialBARKER, KATHRYN (OFFICE MANAGER)