Dental
LSPD at Circle C, PLLC
LSPD at Circle C, PLLC was paid $69K by Medicaid between Nov 2020 and Jun 2021, across 15 billing codes. Its largest line is D1351, Sealant - per tooth — 20% of everything it billed.
33Billing provider infoLSPD AT CIRCLE C, PLLC
AUSTIN, TX 78749
AUSTIN, TX 78749
33aNPI1104364710assigned 02/02/2017
33bProvider typeOrthodontics and Dentofacial Orthopedic Dentist
28Total paid$69K
24GClaims3,374
24DCodes billed15
24AFirst – last monthNov 2020 – Jun 2021
Compared with peers
Next to other Orthodontics and Dentofacial Orthopedic Dentist providers in Texas
Rank by total paid#42 of 87
Median peer was paid$54K
This provider vs. median1.3×
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official MONTGOMERY, MARTY controls 11+ related entities in our dataset. Read more
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 | 715 | $16K | |
| 2021 | 2,659 | $54K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1351 | Sealant - per tooth | 20% | 544 | 121 | $14K |
| D0145 | Oral evaluation for a patient under three years of age | 14% | 71 | 71 | $10K |
| D1120 | Dental cleaning, childProphylaxis - child | 13% | 250 | 246 | $9K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 11% | 274 | 269 | $7K |
| D0272 | Bitewings - two radiographic images | 6.9% | 230 | 223 | $5K |
| D1208 | Topical application of fluoride, excluding varnish | 6.9% | 343 | 337 | $5K |
| D0220 | Intraoral - periapical first radiographic image | 6.2% | 403 | 391 | $4K |
| D0230 | Intraoral - periapical each additional radiographic image | 6.1% | 464 | 369 | $4K |
| D1110 | Prophylaxis - adult | 4.8% | 68 | 66 | $3K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 2.6% | 19 | 12 | $2K |
| D0274 | Bitewings - four radiographic images | 2.5% | 67 | 66 | $2K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.3% | 50 | 48 | $2K |
3 more codes
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 officialMONTGOMERY, MARTY (OWNER)
| Provider | Location | Paid |
|---|---|---|
| North Austin Pediatric Dental, PLLC | Austin, TX | $874K |
| Lone Star Pediatric Dental, PLLC | Austin, TX | $746K |
| Elgin Pediatric Dental PLLC | Elgin, TX | $397K |
| Kyle Pediatric Dental | Kyle, TX | $352K |
| LSPD at Killeen, PLLC | Killeen, TX | $259K |
| T & S Omfs PLLC | Austin, TX | $188K |
| Lakeway Pediatric Dental, PLLC | Austin, TX | $134K |
| Central Austin Pediatric Dental, PLLC | Austin, TX | $122K |
| LSPD at Cove PLLC | Copperas Cove, TX | $106K |
| Dripping Springs Pediatric Dental, PLLC | Dripping Springs, TX | $28K |
| Children's Dental Ranch of New Braunfels, PLLC | New Braunfels, TX | $22K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.