Pine River Dental Arts, P.C.

Pine River Dental Arts, P.C. was paid $42K by Medicaid between Jan 2018 and Jun 2024, across 6 billing codes. Its largest line is D0120, dental checkup, returning patient — 50% of everything it billed.

33Billing provider infoPINE RIVER DENTAL ARTS, P.C.
PINE RIVER, MN 56474

33aNPI1962851071assigned 06/09/2016

33bProvider typeGeneral Practice Dentistry

28Total paid$42K

24GClaims2,000

24DCodes billed6

24AFirst – last monthJan 2018 – Jun 2024

Compared with peers

Next to other General Practice Dentistry providers in Minnesota

Rank by total paid#152 of 368

Median peer was paid$19K

This provider vs. median2.2×

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	542	$340.73
2019	306	$8K
2020	87	$2K
2021	459	$7K
2022	283	$11K
2023	311	$12K
2024incomplete	12	$382.37

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	50%	936	925	$21K
D1110	Prophylaxis - adult	32%	358	355	$13K
D0274	Bitewings - four radiographic images	7.1%	119	118	$3K
D1120	Dental cleaning, childProphylaxis - child	6.7%	194	193	$3K
D1206	Topical application of fluoride varnish	4.5%	188	187	$2K
D9985		0%	205	188	$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 officialPREBLE, JAIME (OWNER)