Long Prairie Dental Clinic LLC

Long Prairie Dental Clinic LLC was paid $2K by Medicaid between Jan 2018 and Jul 2018, across 8 billing codes. Its largest line is D1110, Prophylaxis - adult — 42% of everything it billed.

33Billing provider infoLONG PRAIRIE DENTAL CLINIC LLC
LONG PRAIRIE, MN 56347

33aNPI1811943061assigned 05/26/2006

33bProvider typeDentist

28Total paid$2K

24GClaims1,516

24DCodes billed8

24AFirst – last monthJan 2018 – Jul 2018

Compared with peers

Next to other Dentist providers in Minnesota

Rank by total paid#134 of 192

Median peer was paid$9K

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	1,516	$2K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1110	Prophylaxis - adult	42%	285	235	$853.78
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	37%	466	383	$751.71
D1206	Topical application of fluoride varnish	20%	378	306	$409.09
D0272	Bitewings - two radiographic images	0%	24	13	$0.00
D0274	Bitewings - four radiographic images	0%	149	121	$0.00
D1120	Dental cleaning, childProphylaxis - child	0%	189	148	$0.00
D9230	Inhalation of nitrous oxide / analgesia, anxiolysis	0%	12	12	$0.00
D0220	Intraoral - periapical first radiographic image	0%	13	13	$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 officialGUSTAFSON, MARILYN (OFFICE MANAGER)