Patra Watana DMD Pediatric Dentistry LLC

Patra Watana DMD Pediatric Dentistry LLC was paid $77K by Medicaid between Jan 2018 and Dec 2024, across 7 billing codes. Its largest line is D1206, Topical application of fluoride varnish — 32% of everything it billed.

33Billing provider infoPATRA WATANA DMD PEDIATRIC DENTISTRY LLC
GREENWOOD VILLAGE, CO 80111

33aNPI1093121667assigned 07/03/2014

33bProvider typePediatric Dentist

28Total paid$77K

24GClaims2,861

24DCodes billed7

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Pediatric Dentist providers in Colorado

Rank by total paid#103 of 177

Median peer was paid$122K

This provider vs. median0.6×

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	112	$2K
2019	185	$4K
2020	130	$3K
2021	363	$9K
2022	537	$14K
2023	763	$19K
2024incomplete	771	$27K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1206	Topical application of fluoride varnish	32%	1,133	1,131	$25K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	29%	831	827	$22K
D1120	Dental cleaning, childProphylaxis - child	22%	409	409	$17K
D0272	Bitewings - two radiographic images	8.1%	276	275	$6K
D1110	Prophylaxis - adult	7.5%	105	105	$6K
D0220	Intraoral - periapical first radiographic image	1.1%	64	63	$863.19
D0230	Intraoral - periapical each additional radiographic image	<1%	43	42	$683.39

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 officialWATANA, PATRA (OWNER)