Dental
Lake, Edward
Lake, Edward was paid $21K by Medicaid between Jan 2018 and Jan 2020, across 7 billing codes. Its largest line is D1110, Prophylaxis - adult — 24% of everything it billed.
33Billing provider infoLAKE, EDWARD
POTOSI, MO 63664
POTOSI, MO 63664
33aNPI1790820587assigned 02/20/2007
33bProvider typeDentist
28Total paid$21K
24GClaims1,105
24DCodes billed7
24AFirst – last monthJan 2018 – Jan 2020
Compared with peers
Next to other Dentist providers in Missouri
Rank by total paid#197 of 284
Median peer was paid$109K
This provider vs. median0.2×
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 | 806 | $18K | |
| 2019 | 287 | $3K | |
| 2020 | 12 | $180.00 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 24% | 202 | 198 | $5K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 24% | 254 | 253 | $5K |
| D1206 | Topical application of fluoride varnish | 19% | 333 | 330 | $4K |
| D0330 | Panoramic radiographic image | 14% | 80 | 78 | $3K |
| D0272 | Bitewings - two radiographic images | 9.5% | 160 | 160 | $2K |
| D0150 | Comprehensive oral evaluation - new or established patient | 5.8% | 38 | 38 | $1K |
| D1120 | Dental cleaning, childProphylaxis - child | 3.9% | 38 | 38 | $836.00 |
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.