Dental
Purely Dental Group PLLC S-Corp
Purely Dental Group PLLC S-Corp was paid $395K by Medicaid between Oct 2020 and Dec 2024, across 18 billing codes. Its largest line is D0120, dental checkup, returning patient — 20% of everything it billed.
33Billing provider infoPURELY DENTAL GROUP PLLC S-CORP
ROYSE CITY, TX 75189
ROYSE CITY, TX 75189
33aNPI1073940011assigned 10/05/2013
33bProvider typeDentist
28Total paid$395K
24GClaims21,507
24DCodes billed18
24AFirst – last monthOct 2020 – Dec 2024
Compared with peers
Next to other Dentist providers in Texas
Rank by total paid#374 of 1,678
Median peer was paid$35K
This provider vs. median11×
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 | 730 | $13K | |
| 2021 | 4,504 | $79K | |
| 2022 | 6,489 | $133K | |
| 2023 | 6,212 | $122K | |
| 2024incomplete | 3,572 | $49K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 20% | 2,857 | 2,847 | $80K |
| D1120 | Dental cleaning, childProphylaxis - child | 16% | 1,747 | 1,736 | $62K |
| D1208 | Topical application of fluoride, excluding varnish | 12% | 3,447 | 3,432 | $49K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 12% | 480 | 286 | $46K |
| D0220 | Intraoral - periapical first radiographic image | 8.1% | 2,701 | 2,687 | $32K |
| D0230 | Intraoral - periapical each additional radiographic image | 6.3% | 2,213 | 2,197 | $25K |
| D1351 | Sealant - per tooth | 5.7% | 812 | 195 | $23K |
| D1110 | Prophylaxis - adult | 5.2% | 394 | 393 | $21K |
| D0272 | Bitewings - two radiographic images | 4.8% | 837 | 836 | $19K |
| D0330 | Panoramic radiographic image | 2.5% | 181 | 180 | $10K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 2.5% | 386 | 349 | $10K |
| D0274 | Bitewings - four radiographic images | 1.9% | 218 | 218 | $7K |
6 more codes
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 1.0% | 53 | $4K |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 26 | $4K |
| D0240 | <1% | 193 | $1K | |
| D0210 | Intraoral - complete series of radiographic images | <1% | 13 | $918.32 |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 25 | $883.00 |
| D0603 | 0% | 4,924 | $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 officialDAVONG, ANDY (PRESIDENT)