Dental
Revell-Warrington Dental PC
Revell-Warrington Dental PC was paid $9.25M by Medicaid between Jan 2018 and Dec 2024, across 28 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 22% of everything it billed.
33Billing provider infoREVELL-WARRINGTON DENTAL PC
WEST DES MOINES, IA 50266
WEST DES MOINES, IA 50266
33aNPI1275965246assigned 08/01/2013
33bProvider typePediatric Dentist
28Total paid$9.25M
24GClaims353,497
24DCodes billed28
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Iowa
Rank by total paid#1 of 58
Median peer was paid$284K
This provider vs. median33×
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 | 39,914 | $1.15M | |
| 2019 | 46,489 | $1.22M | |
| 2020 | 55,715 | $1.15M | |
| 2021 | 74,261 | $1.62M | |
| 2022 | 55,933 | $1.56M | |
| 2023 | 43,183 | $1.33M | |
| 2024incomplete | 38,002 | $1.22M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 22% | 20,876 | 6,563 | $2.06M |
| D1120 | Dental cleaning, childProphylaxis - child | 14% | 48,335 | 46,744 | $1.27M |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 9.5% | 42,765 | 41,632 | $876K |
| D1206 | Topical application of fluoride varnish | 9.2% | 54,348 | 52,613 | $851K |
| D1351 | Sealant - per tooth | 7.0% | 32,331 | 6,983 | $648K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 4.7% | 7,551 | 3,079 | $431K |
| D0272 | Bitewings - two radiographic images | 4.2% | 23,113 | 22,210 | $385K |
| D7140 | Extraction, erupted tooth or exposed root | 4.1% | 7,322 | 3,798 | $378K |
| D9248 | 3.5% | 2,449 | 2,301 | $325K | |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 3.0% | 4,081 | 2,424 | $279K |
| D0220 | Intraoral - periapical first radiographic image | 2.7% | 22,705 | 21,653 | $248K |
| D1110 | Prophylaxis - adult | 2.5% | 6,138 | 5,975 | $228K |
16 more codes
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 2.3% | 4,269 | $216K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.0% | 8,389 | $187K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 1.8% | 9,154 | $163K |
| D0230 | Intraoral - periapical each additional radiographic image | 1.7% | 16,593 | $156K |
| D0330 | Panoramic radiographic image | 1.7% | 3,412 | $155K |
| D0145 | Oral evaluation for a patient under three years of age | 1.4% | 5,443 | $132K |
| D0140 | Limited oral evaluation - problem focused | <1% | 3,477 | $91K |
| D0274 | Bitewings - four radiographic images | <1% | 3,195 | $82K |
| D9420 | <1% | 1,336 | $51K | |
| D2934 | <1% | 264 | $30K | |
| D1354 | <1% | 806 | $3K | |
| D2330 | <1% | 54 | $3K | |
| D2335 | <1% | 15 | $1K | |
| D7111 | <1% | 18 | $773.38 | |
| D0240 | <1% | 38 | $491.08 | |
| D1999 | 0% | 25,020 | $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 officialWARRINGTON, JACK (PRESIDENT)