Clinic
Bonney Lake Dental LLC
Bonney Lake Dental LLC was paid $4.81M by Medicaid between Dec 2018 and Dec 2024, across 25 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 19% of everything it billed.
33Billing provider infoBONNEY LAKE DENTAL LLC
BONNEY LAKE, WA 98391
BONNEY LAKE, WA 98391
33aNPI1073088423assigned 10/11/2018
33bProvider typeDental Clinic/Center
28Total paid$4.81M
24GClaims125,796
24DCodes billed25
24AFirst – last monthDec 2018 – Dec 2024
Compared with peers
Next to other Dental Clinic/Center providers in Washington
Rank by total paid#23 of 143
Median peer was paid$573K
This provider vs. median8.4×
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 | 73 | $1K | |
| 2019 | 11,674 | $338K | |
| 2020 | 17,030 | $411K | |
| 2021 | 23,167 | $816K | |
| 2022 | 26,079 | $1.13M | |
| 2023 | 26,470 | $1.18M | |
| 2024incomplete | 21,303 | $935K |
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 | 19% | 13,272 | 6,950 | $893K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 12% | 6,146 | 4,272 | $570K |
| D1110 | Prophylaxis - adult | 10% | 10,331 | 9,873 | $503K |
| D0150 | Comprehensive oral evaluation - new or established patient | 8.4% | 11,472 | 10,645 | $406K |
| D0210 | Intraoral - complete series of radiographic images | 7.2% | 8,712 | 8,085 | $344K |
| D7140 | Extraction, erupted tooth or exposed root | 6.2% | 6,779 | 2,087 | $300K |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 6.2% | 3,474 | 1,926 | $298K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 5.7% | 5,205 | 3,389 | $276K |
| D1208 | Topical application of fluoride, excluding varnish | 3.9% | 9,925 | 9,467 | $186K |
| D2332 | 3.3% | 1,766 | 1,095 | $159K | |
| D2331 | 3.3% | 2,130 | 1,378 | $157K | |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 3.1% | 4,933 | 4,749 | $147K |
13 more codes
| D0140 | Limited oral evaluation - problem focused | 3.1% | 5,450 | $147K |
| D0220 | Intraoral - periapical first radiographic image | 2.3% | 12,247 | $113K |
| D0274 | Bitewings - four radiographic images | 1.8% | 7,095 | $88K |
| D2335 | <1% | 477 | $47K | |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 8,379 | $38K |
| D1999 | <1% | 4,036 | $34K | |
| D1206 | Topical application of fluoride varnish | <1% | 1,346 | $25K |
| D2330 | <1% | 457 | $24K | |
| D4341 | <1% | 974 | $22K | |
| D1120 | Dental cleaning, child | <1% | 1,107 | $22K |
| D3310 | <1% | 17 | $8K | |
| D2394 | <1% | 48 | $6K | |
| D0330 | Panoramic radiographic image | <1% | 18 | $344.08 |
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 officialPROBST, TRAVIS (OWNER /DENTIST)
| Provider | Location | Paid |
|---|---|---|
| Fairwood Pedodonticsllc | Renton, WA | $1.33M |
| Fairwood Dental LLC | Renton, WA | $1.20M |
| Lake Meridian Dental LLC | Kent, WA | $435K |
| Puyallup Dental, LLC | Puyallup, WA | $84K |
| North Lakewood Dental PLCC | Lakewood, WA | $30K |
| Port Orchard Dental LLC | Port Orchard, WA | $7K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.