Dental
Pediatric Dental Care
Pediatric Dental Care was paid $573K by Medicaid between Jan 2018 and Dec 2022, across 19 billing codes. Its largest line is D0120, dental checkup, returning patient — 45% of everything it billed.
33Billing provider infoPEDIATRIC DENTAL CARE
SPANISH FORK, UT 84660
SPANISH FORK, UT 84660
33aNPI1174070015assigned 09/08/2016
33bProvider typeDentist
28Total paid$573K
24GClaims20,712
24DCodes billed19
24AFirst – last monthJan 2018 – Dec 2022
Compared with peers
Next to other Dentist providers in Utah
Rank by total paid#10 of 136
Median peer was paid$35K
This provider vs. median16×
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 | 5,650 | $143K | |
| 2019 | 2,198 | $60K | |
| 2020 | 2,160 | $70K | |
| 2021 | 6,302 | $192K | |
| 2022 | 4,402 | $109K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 45% | 3,597 | 3,580 | $256K |
| D1120 | Dental cleaning, childProphylaxis - child | 31% | 3,783 | 3,743 | $177K |
| D0272 | Bitewings - two radiographic images | 5.6% | 2,636 | 2,609 | $32K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 5.2% | 562 | 159 | $30K |
| D1351 | Sealant - per tooth | 3.0% | 558 | 122 | $17K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.1% | 108 | 108 | $12K |
| D0220 | Intraoral - periapical first radiographic image | 2.1% | 2,220 | 2,202 | $12K |
| D7140 | Extraction, erupted tooth or exposed root | 1.7% | 275 | 137 | $10K |
| D2150 | Silver amalgam - two surfaces, primary or permanent | 1.5% | 201 | 143 | $9K |
| D2140 | <1% | 51 | 42 | $5K | |
| D1206 | Topical application of fluoride varnish | <1% | 3,796 | 3,756 | $4K |
| D0140 | Limited oral evaluation - problem focused | <1% | 50 | 50 | $3K |
7 more codes
| D1110 | Prophylaxis - adult | <1% | 13 | $2K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | <1% | 17 | $1K |
| D9420 | <1% | 13 | $1K | |
| D0330 | Panoramic radiographic image | <1% | 142 | $849.90 |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 1,920 | $533.04 |
| D0274 | Bitewings - four radiographic images | <1% | 745 | $476.14 |
| D1208 | Topical application of fluoride, excluding varnish | 0% | 25 | $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 officialSORENSEN, BRET (OWNER)