Dental
Kamilche Dental Center
Kamilche Dental Center was paid $166K by Medicaid between Jan 2018 and Oct 2024, across 14 billing codes. Its largest line is D7210, Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth — 32% of everything it billed.
33Billing provider infoKAMILCHE DENTAL CENTER
SHELTON, WA 98584
SHELTON, WA 98584
33aNPI1043379480assigned 12/08/2006
33bProvider typeDenturist
28Total paid$166K
24GClaims6,088
24DCodes billed14
24AFirst – last monthJan 2018 – Oct 2024
Compared with peers
Next to other Denturist providers in Washington
Rank by total paid#24 of 55
Median peer was paid$125K
This provider vs. median1.3×
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 | 1,313 | $17K | |
| 2019 | 1,429 | $17K | |
| 2020 | 1,186 | $14K | |
| 2021 | 1,263 | $50K | |
| 2022 | 432 | $35K | |
| 2023 | 236 | $15K | |
| 2024incomplete | 229 | $18K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 32% | 459 | 143 | $54K |
| D0140 | Limited oral evaluation - problem focused | 15% | 1,079 | 1,065 | $25K |
| D5110 | 14% | 36 | 36 | $23K | |
| D0210 | Intraoral - complete series of radiographic images | 8.3% | 351 | 349 | $14K |
| D0150 | Comprehensive oral evaluation - new or established patient | 5.5% | 220 | 220 | $9K |
| D4341 | 5.4% | 277 | 91 | $9K | |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 5.3% | 367 | 367 | $9K |
| D0220 | Intraoral - periapical first radiographic image | 4.8% | 958 | 926 | $8K |
| D1999 | 4.2% | 512 | 406 | $7K | |
| D0230 | Intraoral - periapical each additional radiographic image | 1.6% | 1,612 | 318 | $3K |
| D1208 | Topical application of fluoride, excluding varnish | 1.5% | 155 | 154 | $2K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 1.1% | 21 | 13 | $2K |
2 more codes
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 officialPETERS, STEVEN (OWNER)