Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › OR › ONTARIO › JOHN F LAKE DDS & DEBORAH STARR

JOHN F LAKE DDS & DEBORAH STARR

NPI: 1487862009 · ONTARIO, OR 97914 · General Practice Dentistry · NPI assigned 05/18/2007

$23K
Total Medicaid Paid
819
Total Claims
810
Beneficiaries
5
Codes Billed
2018-01
First Month
2019-02
Last Month

Provider Details

Authorized OfficialLAKE, JOHN (PRESIDENT)
NPI Enumeration Date05/18/2007

Related Entities

Other providers sharing the same authorized official: LAKE, JOHN

ProviderCityStateTotal Paid
NEWBERRY DENTAL, PC NEWBERRY SC $58K
MID-CAROLINA DENTAL CARE, INC PROSPERITY SC $194.40

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 644 $18K
2019 175 $5K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1120 Prophylaxis - child 199 199 $8K
D0120 Periodic oral evaluation - established patient 277 277 $8K
D1208 Topical application of fluoride, excluding varnish 284 284 $5K
D2391 Resin-based composite - one surface, posterior, primary or permanent 33 24 $2K
D1110 Prophylaxis - adult 26 26 $1K