Clinic
Vista Ridge Dental Arts Studio, LLC
Vista Ridge Dental Arts Studio, LLC was paid $327K by Medicaid between Apr 2018 and Jul 2021, across 17 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 18% of everything it billed.
33Billing provider infoVISTA RIDGE DENTAL ARTS STUDIO, LLC
JOHNSON CITY, TN 37604
JOHNSON CITY, TN 37604
33aNPI1154837292assigned 12/27/2017
33bProvider typeDental Clinic/Center
28Total paid$327K
24GClaims10,127
24DCodes billed17
24AFirst – last monthApr 2018 – Jul 2021
Compared with peers
Next to other Dental Clinic/Center providers in Tennessee
Rank by total paid#19 of 40
Median peer was paid$259K
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.
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 | 2,172 | $65K | |
| 2019 | 4,251 | $148K | |
| 2020 | 2,547 | $76K | |
| 2021 | 1,157 | $38K |
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 | 18% | 851 | 587 | $60K |
| D1110 | Prophylaxis - adult | 18% | 1,451 | 1,417 | $57K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 12% | 1,753 | 1,716 | $40K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 9.6% | 382 | 273 | $31K |
| D0274 | Bitewings - four radiographic images | 7.9% | 1,002 | 985 | $26K |
| D1120 | Dental cleaning, childProphylaxis - child | 7.7% | 804 | 795 | $25K |
| D1208 | Topical application of fluoride, excluding varnish | 6.1% | 1,035 | 1,011 | $20K |
| D1206 | Topical application of fluoride varnish | 5.5% | 926 | 907 | $18K |
| D0330 | Panoramic radiographic image | 4.9% | 488 | 477 | $16K |
| D0150 | Comprehensive oral evaluation - new or established patient | 3.9% | 469 | 457 | $13K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 2.9% | 162 | 123 | $9K |
| D0272 | Bitewings - two radiographic images | 1.6% | 304 | 300 | $5K |
5 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 officialMOODY, AMY (DENTIST/SOLE MBR)