Dental
Gladstone, Tess
Gladstone, Tess was paid $1.15M by Medicaid between Sep 2018 and Dec 2024, across 30 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 21% of everything it billed.
33Billing provider infoGLADSTONE, TESS
KEIZER, OR 97303
KEIZER, OR 97303
33aNPI1356720908assigned 05/28/2015
33bProvider typePediatric Dentist
28Total paid$1.15M
24GClaims47,512
24DCodes billed30
24AFirst – last monthSep 2018 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Oregon
Rank by total paid#21 of 109
Median peer was paid$362K
This provider vs. median3.2×
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 | 331 | $5K | |
| 2019 | 2,702 | $72K | |
| 2020 | 83 | $1K | |
| 2022 | 22,935 | $511K | |
| 2023 | 11,698 | $310K | |
| 2024incomplete | 9,763 | $249K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 21% | 2,372 | 685 | $237K |
| D1120 | Dental cleaning, childProphylaxis - child | 17% | 5,058 | 5,041 | $200K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 8.2% | 3,414 | 3,406 | $94K |
| D1206 | Topical application of fluoride varnish | 8.1% | 4,951 | 4,935 | $93K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 6.5% | 1,079 | 628 | $75K |
| D1351 | Sealant - per tooth | 5.4% | 1,819 | 540 | $62K |
| D7140 | Extraction, erupted tooth or exposed root | 5.3% | 815 | 342 | $61K |
| D0230 | Intraoral - periapical each additional radiographic image | 3.4% | 4,754 | 1,369 | $40K |
| D0150 | Comprehensive oral evaluation - new or established patient | 3.1% | 976 | 974 | $36K |
| D0272 | Bitewings - two radiographic images | 3.0% | 2,159 | 2,150 | $35K |
| D0603 | 2.5% | 4,371 | 4,349 | $29K | |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 2.3% | 1,015 | 979 | $27K |
18 more codes
| D0240 | 2.2% | 1,594 | $25K | |
| D0220 | Intraoral - periapical first radiographic image | 2.0% | 1,873 | $23K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 1.7% | 283 | $19K |
| D2929 | 1.4% | 161 | $16K | |
| D0210 | Intraoral - complete series of radiographic images | 1.4% | 297 | $16K |
| D0145 | Oral evaluation for a patient under three years of age | 1.2% | 530 | $14K |
| D0140 | Limited oral evaluation - problem focused | 1.2% | 409 | $13K |
| D1354 | <1% | 2,330 | $7K | |
| D1510 | <1% | 55 | $6K | |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 97 | $5K |
| D0330 | Panoramic radiographic image | <1% | 447 | $5K |
| D9248 | <1% | 25 | $3K | |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 37 | $3K |
| D9310 | <1% | 28 | $1K | |
| D0274 | Bitewings - four radiographic images | <1% | 50 | $955.55 |
| D0602 | <1% | 49 | $308.00 | |
| D1330 | <1% | 3,236 | $10.28 | |
| D1310 | <1% | 3,228 | $10.06 |
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.