Dental
Katahdin Pediatric Dentistry
Katahdin Pediatric Dentistry was paid $179K by Medicaid between Jan 2018 and May 2019, across 19 billing codes. Its largest line is D1120, dental cleaning, child — 24% of everything it billed.
33Billing provider infoKATAHDIN PEDIATRIC DENTISTRY
BANGOR, ME 04401
BANGOR, ME 04401
33aNPI1013274067assigned 04/16/2012
33bProvider typePediatric Dentist
28Total paid$179K
24GClaims7,985
24DCodes billed19
24AFirst – last monthJan 2018 – May 2019
Compared with peers
Next to other Pediatric Dentist providers in Maine
Rank by total paid#15 of 17
Median peer was paid$748K
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 | 5,863 | $132K | |
| 2019 | 2,122 | $47K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 24% | 1,604 | 1,563 | $42K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 23% | 1,608 | 1,576 | $42K |
| D7140 | Extraction, erupted tooth or exposed root | 11% | 262 | 139 | $20K |
| D1206 | Topical application of fluoride varnish | 11% | 1,854 | 1,804 | $20K |
| D1110 | Prophylaxis - adult | 6.2% | 360 | 349 | $11K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 5.8% | 590 | 550 | $10K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 5.8% | 96 | 38 | $10K |
| D0170 | 3.4% | 335 | 323 | $6K | |
| D1351 | Sealant - per tooth | 2.5% | 346 | 79 | $4K |
| D0272 | Bitewings - two radiographic images | 2.3% | 309 | 300 | $4K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 1.8% | 40 | 28 | $3K |
| D0330 | Panoramic radiographic image | 1.4% | 63 | 63 | $2K |
7 more codes
| D0220 | Intraoral - periapical first radiographic image | <1% | 226 | $2K |
| D0140 | Limited oral evaluation - problem focused | <1% | 26 | $500.00 |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 12 | $495.00 |
| D1330 | <1% | 28 | $279.31 | |
| D9920 | <1% | 14 | $156.00 | |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 25 | $110.50 |
| D8670 | Periodic orthodontic treatment visit | <1% | 187 | $66.00 |
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 officialTO'OLO, GASTON (PEDIATRIC DENTIST)
| Provider | Location | Paid |
|---|---|---|
| Katahdin Pediatric's PA | Bangor, ME | $748K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.