Dental
Moonlight Smiles, PLLC
Moonlight Smiles, PLLC was paid $1.80M by Medicaid between Oct 2020 and Dec 2024, across 21 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 27% of everything it billed.
33Billing provider infoMOONLIGHT SMILES, PLLC
MCALLEN, TX 78503
MCALLEN, TX 78503
33aNPI1043784390assigned 01/18/2019
33bProvider typeGeneral Practice Dentistry
28Total paid$1.80M
24GClaims68,954
24DCodes billed21
24AFirst – last monthOct 2020 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in Texas
Rank by total paid#198 of 2,774
Median peer was paid$43K
This provider vs. median42×
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 | |
|---|---|---|---|
| 2020 | 1,665 | $45K | |
| 2021 | 16,092 | $445K | |
| 2022 | 19,897 | $533K | |
| 2023 | 16,097 | $414K | |
| 2024incomplete | 15,203 | $361K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 27% | 4,980 | 2,055 | $479K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 14% | 3,242 | 1,558 | $246K |
| D1351 | Sealant - per tooth | 8.2% | 5,614 | 1,558 | $148K |
| D0230 | Intraoral - periapical each additional radiographic image | 6.0% | 13,733 | 5,795 | $107K |
| D1120 | Dental cleaning, childProphylaxis - child | 5.5% | 2,868 | 2,828 | $99K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 5.1% | 3,301 | 3,269 | $91K |
| D0150 | Comprehensive oral evaluation - new or established patient | 4.8% | 2,573 | 2,525 | $86K |
| D1110 | Prophylaxis - adult | 4.8% | 1,775 | 1,756 | $86K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 4.5% | 3,092 | 2,975 | $81K |
| D0274 | Bitewings - four radiographic images | 4.0% | 2,583 | 2,553 | $73K |
| D1208 | Topical application of fluoride, excluding varnish | 3.6% | 4,739 | 4,673 | $65K |
| D0330 | Panoramic radiographic image | 2.8% | 2,070 | 2,032 | $51K |
9 more codes
| D0220 | Intraoral - periapical first radiographic image | 2.8% | 6,183 | $50K |
| D0272 | Bitewings - two radiographic images | 2.4% | 2,360 | $44K |
| D0145 | Oral evaluation for a patient under three years of age | 2.3% | 305 | $42K |
| D0210 | Intraoral - complete series of radiographic images | 1.3% | 374 | $23K |
| D1330 | <1% | 1,014 | $10K | |
| D0350 | <1% | 673 | $7K | |
| D0250 | <1% | 505 | $6K | |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 49 | $5K |
| D0603 | 0% | 6,921 | $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 officialSOTO, JOSE (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Siete Leguas LLC | New Braunfels, TX | $345K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.