Dental
Waggoner Professional Services PC
Waggoner Professional Services PC was paid $1.05M by Medicaid between Nov 2018 and Feb 2024, across 26 billing codes. Its largest line is D1120, dental cleaning, child — 20% of everything it billed.
33Billing provider infoWAGGONER PROFESSIONAL SERVICES PC
LAS VEGAS, NV 89147
LAS VEGAS, NV 89147
33aNPI1295259760assigned 07/27/2017
33bProvider typePediatric Dentist
28Total paid$1.05M
24GClaims41,523
24DCodes billed26
24AFirst – last monthNov 2018 – Feb 2024
Compared with peers
Next to other Pediatric Dentist providers in Nevada
Rank by total paid#19 of 85
Median peer was paid$244K
This provider vs. median4.3×
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 | 200 | $8K | |
| 2019 | 2,362 | $77K | |
| 2020 | 9,057 | $256K | |
| 2021 | 13,476 | $327K | |
| 2022 | 9,764 | $218K | |
| 2023 | 5,704 | $141K | |
| 2024incomplete | 960 | $24K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 20% | 4,899 | 4,697 | $206K |
| D1206 | Topical application of fluoride varnish | 15% | 4,947 | 4,744 | $160K |
| D9248 | 11% | 1,398 | 1,249 | $116K | |
| D1351 | Sealant - per tooth | 9.4% | 4,506 | 1,161 | $98K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 8.6% | 3,711 | 3,595 | $91K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 7.4% | 1,581 | 959 | $77K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 4.7% | 769 | 489 | $49K |
| D7140 | Extraction, erupted tooth or exposed root | 4.5% | 1,250 | 768 | $47K |
| D0272 | Bitewings - two radiographic images | 3.6% | 2,401 | 2,276 | $38K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 2.9% | 830 | 606 | $31K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.9% | 1,009 | 957 | $30K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 2.6% | 2,927 | 2,587 | $28K |
14 more codes
| D0330 | Panoramic radiographic image | 2.2% | 641 | $23K |
| D0240 | 1.6% | 937 | $16K | |
| D0140 | Limited oral evaluation - problem focused | 1.1% | 363 | $11K |
| D0999 | Unspecified diagnostic procedure, by report | <1% | 236 | $7K |
| D9999 | Unspecified adjunctive procedure, by report | <1% | 259 | $6K |
| D0220 | Intraoral - periapical first radiographic image | <1% | 552 | $5K |
| D0274 | Bitewings - four radiographic images | <1% | 217 | $5K |
| D0603 | <1% | 1,376 | $2K | |
| D1353 | <1% | 166 | $2K | |
| D0602 | <1% | 598 | $470.25 | |
| D3120 | <1% | 29 | $435.20 | |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 62 | $347.51 |
| D0601 | <1% | 154 | $135.25 | |
| D1999 | 0% | 5,705 | $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 officialANTUNA, LISA (PRACTICE MANAGER)