Pederson, Michael

Pederson, Michael was paid $1K by Medicaid between Jun 2019 and Aug 2019, across 2 billing codes. Its largest line is D0120, dental checkup, returning patient — 80% of everything it billed.

33Billing provider infoPEDERSON, MICHAEL
WALKER, MN 56484

33aNPI1548297039assigned 06/28/2006

33bProvider typeGeneral Practice Dentistry

28Total paid$1K

24GClaims55

24DCodes billed2

24AFirst – last monthJun 2019 – Aug 2019

Compared with peers

Next to other General Practice Dentistry providers in Minnesota

Rank by total paid#283 of 368

Median peer was paid$19K

This provider vs. median0.1×

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
2019	55	$1K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	80%	41	41	$998.55
D1206	Topical application of fluoride varnish	20%	14	14	$244.51

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.