Lac, My

Lac, My was paid $365K by Medicaid between Aug 2022 and Dec 2024, across 19 billing codes. Its largest line is D1110, Prophylaxis - adult — 18% of everything it billed.

33Billing provider infoLAC, MY
PORTLAND, OR 97220

33aNPI1952034738assigned 07/08/2022

33bProvider typeGeneral Practice Dentistry

28Total paid$365K

24GClaims9,486

24DCodes billed19

24AFirst – last monthAug 2022 – Dec 2024

Compared with peers

Next to other General Practice Dentistry providers in Oregon

Rank by total paid#28 of 311

Median peer was paid$6K

This provider vs. median57×

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
2022	1,294	$36K
2023	4,096	$151K
2024incomplete	4,096	$177K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1110	Prophylaxis - adult	18%	1,117	1,117	$64K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	11%	1,174	1,174	$40K
D4910		10%	410	409	$37K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	9.7%	340	207	$35K
D1208	Topical application of fluoride, excluding varnish	9.4%	1,652	1,651	$34K
D4341		6.7%	179	80	$24K
D0150	Comprehensive oral evaluation - new or established patient	6.6%	515	515	$24K
D0210	Intraoral - complete series of radiographic images	6.4%	374	374	$23K
D0274	Bitewings - four radiographic images	5.5%	586	586	$20K
D0220	Intraoral - periapical first radiographic image	4.4%	1,089	1,061	$16K
D2391	Resin-based composite - one surface, posterior, primary or permanent	4.0%	193	122	$14K
D0230	Intraoral - periapical each additional radiographic image	3.1%	990	823	$11K

7 more codes

D0140	Limited oral evaluation - problem focused	1.5%	144	$6K
D0603		1.3%	408	$5K
D7140	Extraction, erupted tooth or exposed root	1.1%	44	$4K
D4342		<1%	23	$2K
D2393	Resin-based composite - three surfaces, posterior, primary or permanent	<1%	14	$2K
D0602		<1%	109	$1K
D1330		<1%	125	$228.00

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.