Dental
Lake Superior Dental Associates
Lake Superior Dental Associates was paid $122K by Medicaid between Jan 2018 and Nov 2024, across 9 billing codes. Its largest line is D1110, Prophylaxis - adult — 46% of everything it billed.
33Billing provider infoLAKE SUPERIOR DENTAL ASSOCIATES
DULUTH, MN 55805
DULUTH, MN 55805
33aNPI1871672584assigned 11/03/2006
33bProvider typeGeneral Practice Dentistry
28Total paid$122K
24GClaims4,408
24DCodes billed9
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other General Practice Dentistry providers in Minnesota
Rank by total paid#112 of 368
Median peer was paid$19K
This provider vs. median6.4×
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 | 259 | $1K | |
| 2019 | 496 | $14K | |
| 2020 | 523 | $13K | |
| 2021 | 1,418 | $34K | |
| 2022 | 902 | $33K | |
| 2023 | 454 | $15K | |
| 2024incomplete | 356 | $12K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 46% | 1,364 | 1,357 | $56K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 29% | 1,610 | 1,598 | $35K |
| D1206 | Topical application of fluoride varnish | 14% | 905 | 897 | $17K |
| D0274 | Bitewings - four radiographic images | 9.1% | 386 | 384 | $11K |
| D0140 | Limited oral evaluation - problem focused | <1% | 39 | 39 | $1K |
| D1120 | Dental cleaning, childProphylaxis - child | <1% | 31 | 31 | $801.67 |
| D0220 | Intraoral - periapical first radiographic image | <1% | 44 | 42 | $472.85 |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 15 | 14 | $175.05 |
| D9985 | 0% | 14 | 12 | $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 officialRYAN, ROBERT (PARTNER)
| Provider | Location | Paid |
|---|---|---|
| Mountain Oral & Maxillofacial Surgery | Arvada, CO | $39K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.