Clinic
Granger Pediatric Dentistry
Granger Pediatric Dentistry was paid $2.41M by Medicaid between Sep 2018 and Dec 2024, across 23 billing codes. Its largest line is D0120, dental checkup, returning patient — 37% of everything it billed.
33Billing provider infoGRANGER PEDIATRIC DENTISTRY
WEST VALLEY CITY, UT 84119
WEST VALLEY CITY, UT 84119
33aNPI1154637825assigned 08/19/2010
33bProvider typeDental Clinic/Center
28Total paid$2.41M
24GClaims70,892
24DCodes billed23
24AFirst – last monthSep 2018 – Dec 2024
Compared with peers
Next to other Dental Clinic/Center providers in Utah
Rank by total paid#4 of 37
Median peer was paid$90K
This provider vs. median27×
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 | 1,415 | $47K | |
| 2019 | 5,443 | $192K | |
| 2020 | 4,621 | $165K | |
| 2021 | 6,366 | $218K | |
| 2022 | 20,566 | $720K | |
| 2023 | 18,263 | $607K | |
| 2024incomplete | 14,218 | $459K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 37% | 9,638 | 9,598 | $886K |
| D1351 | Sealant - per tooth | 9.6% | 6,273 | 1,085 | $232K |
| D0220 | Intraoral - periapical first radiographic image | 7.4% | 5,783 | 5,652 | $178K |
| D1120 | Dental cleaning, childProphylaxis - child | 7.2% | 9,936 | 9,894 | $174K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 6.4% | 2,481 | 1,005 | $153K |
| D0272 | Bitewings - two radiographic images | 6.1% | 5,113 | 5,083 | $147K |
| D1206 | Topical application of fluoride varnish | 3.7% | 10,627 | 10,582 | $90K |
| D0150 | Comprehensive oral evaluation - new or established patient | 3.4% | 731 | 724 | $82K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 3.3% | 1,420 | 714 | $81K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 2.9% | 883 | 288 | $70K |
| D0230 | Intraoral - periapical each additional radiographic image | 2.7% | 9,591 | 4,250 | $65K |
| D7140 | Extraction, erupted tooth or exposed root | 2.4% | 1,021 | 513 | $57K |
11 more codes
| D0330 | Panoramic radiographic image | 1.9% | 1,228 | $45K |
| D0274 | Bitewings - four radiographic images | 1.8% | 2,304 | $44K |
| D1110 | Prophylaxis - adult | <1% | 528 | $23K |
| D0140 | Limited oral evaluation - problem focused | <1% | 493 | $20K |
| D2140 | <1% | 850 | $15K | |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | <1% | 449 | $15K |
| D2150 | Silver amalgam - two surfaces, primary or permanent | <1% | 1,441 | $13K |
| D9420 | <1% | 25 | $11K | |
| D2330 | <1% | 24 | $3K | |
| D9248 | <1% | 28 | $3K | |
| D2332 | <1% | 25 | $2K |
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 officialPETERSEN, HANS (OWNER/DENTIST)