Dental
Pediatric Dentistry P.L.C.
Pediatric Dentistry P.L.C. was paid $462K by Medicaid between Jan 2018 and Dec 2024, across 17 billing codes. Its largest line is D0120, dental checkup, returning patient — 28% of everything it billed.
33Billing provider infoPEDIATRIC DENTISTRY P.L.C.
SARTELL, MN 56377
SARTELL, MN 56377
33aNPI1780938688assigned 10/31/2012
33bProvider typePediatric Dentist
28Total paid$462K
24GClaims22,945
24DCodes billed17
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Minnesota
Rank by total paid#17 of 49
Median peer was paid$94K
This provider vs. median4.9×
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 | 5,260 | $23K | |
| 2019 | 3,279 | $76K | |
| 2020 | 2,400 | $52K | |
| 2021 | 3,384 | $53K | |
| 2022 | 2,930 | $88K | |
| 2023 | 2,847 | $78K | |
| 2024incomplete | 2,845 | $92K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 28% | 5,266 | 5,180 | $128K |
| D1120 | Dental cleaning, childProphylaxis - child | 23% | 4,780 | 4,694 | $107K |
| D1206 | Topical application of fluoride varnish | 19% | 4,991 | 4,884 | $87K |
| D0272 | Bitewings - two radiographic images | 10% | 2,412 | 2,347 | $48K |
| D1330 | 5.2% | 936 | 923 | $24K | |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 2.9% | 381 | 218 | $13K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 2.5% | 975 | 895 | $12K |
| D1110 | Prophylaxis - adult | 2.4% | 246 | 245 | $11K |
| D0274 | Bitewings - four radiographic images | 2.1% | 284 | 276 | $10K |
| D0220 | Intraoral - periapical first radiographic image | 1.8% | 646 | 624 | $8K |
| D9920 | <1% | 238 | 224 | $4K | |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 184 | 120 | $4K |
5 more codes
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 officialLUCAS, LILIANA (DENTIST)