Clinic
Sage Dentistry V PLLC
Sage Dentistry V PLLC was paid $15K by Medicaid between Dec 2019 and Mar 2022, across 6 billing codes. Its largest line is D1110, Prophylaxis - adult — 43% of everything it billed.
33Billing provider infoSAGE DENTISTRY V PLLC
LAKEWOOD, CO 80226
LAKEWOOD, CO 80226
33aNPI1073034088assigned 06/29/2017
33bProvider typeDental Clinic/Center
28Total paid$15K
24GClaims371
24DCodes billed6
24AFirst – last monthDec 2019 – Mar 2022
Compared with peers
Next to other Dental Clinic/Center providers in Colorado
Rank by total paid#154 of 193
Median peer was paid$180K
This provider vs. median0.1×
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 | |
|---|---|---|---|
| 2019 | 14 | $495.30 | |
| 2020 | 105 | $3K | |
| 2021 | 239 | $11K | |
| 2022 | 13 | $580.19 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 43% | 156 | 156 | $6K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 23% | 26 | 12 | $3K |
| D0150 | Comprehensive oral evaluation - new or established patient | 22% | 87 | 87 | $3K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 7.9% | 52 | 52 | $1K |
| D0220 | Intraoral - periapical first radiographic image | 3.1% | 38 | 38 | $463.66 |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 12 | 12 | $144.24 |
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 officialPOLLACK, SAGE (DOCTOR/OWNER)
| Provider | Location | Paid |
|---|---|---|
| Sage Dentistry IV PLLC | Lafayette, CO | $75K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.