Dental
South Valley Pediatric Dentistry
South Valley Pediatric Dentistry was paid $894K by Medicaid between Sep 2018 and Aug 2024, across 16 billing codes. Its largest line is D1120, dental cleaning, child — 27% of everything it billed.
33Billing provider infoSOUTH VALLEY PEDIATRIC DENTISTRY
SPRINGVILLE, UT 84663
SPRINGVILLE, UT 84663
33aNPI1336465830assigned 04/09/2010
33bProvider typePediatric Dentist
28Total paid$894K
24GClaims26,056
24DCodes billed16
24AFirst – last monthSep 2018 – Aug 2024
Compared with peers
Next to other Pediatric Dentist providers in Utah
Rank by total paid#40 of 152
Median peer was paid$311K
This provider vs. median2.9×
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 | 913 | $23K | |
| 2019 | 6,031 | $205K | |
| 2020 | 5,314 | $187K | |
| 2021 | 6,166 | $226K | |
| 2022 | 6,471 | $225K | |
| 2023 | 736 | $17K | |
| 2024incomplete | 425 | $10K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 27% | 3,823 | 3,810 | $243K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 17% | 3,327 | 3,312 | $156K |
| D2150 | Silver amalgam - two surfaces, primary or permanent | 13% | 1,629 | 746 | $119K |
| D1351 | Sealant - per tooth | 9.5% | 2,401 | 572 | $85K |
| D0272 | Bitewings - two radiographic images | 5.3% | 3,506 | 3,482 | $47K |
| D0230 | Intraoral - periapical each additional radiographic image | 4.8% | 2,378 | 2,228 | $43K |
| D1206 | Topical application of fluoride varnish | 4.6% | 3,985 | 3,966 | $41K |
| D2140 | 4.2% | 547 | 293 | $38K | |
| D0150 | Comprehensive oral evaluation - new or established patient | 3.5% | 529 | 525 | $31K |
| D0220 | Intraoral - periapical first radiographic image | 2.6% | 2,860 | 2,806 | $23K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 2.4% | 147 | 42 | $21K |
| D7140 | Extraction, erupted tooth or exposed root | 2.0% | 174 | 93 | $18K |
4 more codes
| D0330 | Panoramic radiographic image | 1.4% | 537 | $13K |
| D0140 | Limited oral evaluation - problem focused | <1% | 143 | $6K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | <1% | 25 | $5K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | <1% | 45 | $5K |
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 officialCATMULL, ANGIE (OFFICE MANAGER)