Clinic
Diamond Trail Dental PC
Diamond Trail Dental PC was paid $4K by Medicaid between Apr 2018 and Jun 2021, across 5 billing codes. Its largest line is D1120, dental cleaning, child — 39% of everything it billed.
33Billing provider infoDIAMOND TRAIL DENTAL PC
MONTEZUMA, IA 50171
MONTEZUMA, IA 50171
33aNPI1164761698assigned 02/04/2013
33bProvider typeDental Clinic/Center
28Total paid$4K
24GClaims261
24DCodes billed5
24AFirst – last monthApr 2018 – Jun 2021
Compared with peers
Next to other Dental Clinic/Center providers in Iowa
Rank by total paid#42 of 61
Median peer was paid$33K
This provider vs. median0.1×
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 | 26 | $484.45 | |
| 2020 | 209 | $3K | |
| 2021 | 26 | $612.49 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 39% | 54 | 51 | $2K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 35% | 68 | 67 | $2K |
| D1206 | Topical application of fluoride varnish | 21% | 56 | 53 | $915.21 |
| D0272 | Bitewings - two radiographic images | 4.9% | 14 | 12 | $212.17 |
| D1999 | 0% | 69 | 63 | $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 officialDEBOEF, ERIC (PRESIDENT)