Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Dental

Lone Star Pediatric Dental, PLLC

Lone Star Pediatric Dental, PLLC was paid $746K by Medicaid between Jul 2018 and Jun 2021, across 21 billing codes. Its largest line is D0120, dental checkup, returning patient — 13% of everything it billed.

33Billing provider infoLONE STAR PEDIATRIC DENTAL, PLLC
AUSTIN, TX 78704
33aNPI1376854364assigned 06/24/2010
33bProvider typePediatric Dentist
28Total paid$746K
24GClaims32,251
24DCodes billed21
24AFirst – last monthJul 2018 – Jun 2021
Compared with peers

Next to other Pediatric Dentist providers in Texas

Rank by total paid#225 of 693
Median peer was paid$252K
This provider vs. median3.0×

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.

Auditor's notes

Automated statistical signals. Not evidence of fraud — how these are computed.

Entity ProliferationAuthorized official MONTGOMERY, MARTY controls 11+ related entities in our dataset. Read more
Box 24A · Dates of service

Paid by month

$0$50K$100K$150K2018201920202021202220232024
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
YearClaimsPaid
2018350$4K
2019394$5K
20206,403$149K
202125,104$588K
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
D0120 Dental checkup, returning patientPeriodic oral evaluation - established patient 13% 3,424 3,411 $97K
D1120 Dental cleaning, childProphylaxis - child 12% 2,511 2,500 $90K
D1351 Sealant - per tooth 12% 3,275 878 $90K
D0145 Oral evaluation for a patient under three years of age 10% 557 552 $78K
D1208 Topical application of fluoride, excluding varnish 7.2% 3,717 3,702 $54K
D1110 Prophylaxis - adult 7.0% 977 973 $53K
D0272 Bitewings - two radiographic images 6.3% 2,167 2,158 $47K
D0220 Intraoral - periapical first radiographic image 6.0% 3,964 3,916 $45K
D0230 Intraoral - periapical each additional radiographic image 5.3% 3,890 3,650 $40K
D0274 Bitewings - four radiographic images 4.0% 965 962 $30K
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 3.9% 316 155 $29K
D9248 2.7% 176 168 $20K
9 more codes
D2391 Resin-based composite - one surface, posterior, primary or permanent 2.7% 260 $20K
D2930 Prefabricated stainless steel crown - primary tooth 1.8% 94 $14K
D0210 Intraoral - complete series of radiographic images 1.5% 167 $11K
D9230 Inhalation of nitrous oxide / analgesia, anxiolysis 1.2% 344 $9K
D0150 Comprehensive oral evaluation - new or established patient <1% 186 $6K
D0330 Panoramic radiographic image <1% 417 $6K
D7140 Extraction, erupted tooth or exposed root <1% 111 $6K
D0140 Limited oral evaluation - problem focused <1% 170 $3K
D0603 0% 4,563 $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 officialMONTGOMERY, MARTY (OWNER)
Same official

Other billing entities under MONTGOMERY, MARTY

Full network →
ProviderLocationPaid
North Austin Pediatric Dental, PLLCAustin, TX$874K
Elgin Pediatric Dental PLLCElgin, TX$397K
Kyle Pediatric DentalKyle, TX$352K
LSPD at Killeen, PLLCKilleen, TX$259K
T & S Omfs PLLCAustin, TX$188K
Lakeway Pediatric Dental, PLLCAustin, TX$134K
Central Austin Pediatric Dental, PLLCAustin, TX$122K
LSPD at Cove PLLCCopperas Cove, TX$106K
LSPD at Circle C, PLLCAustin, TX$69K
Dripping Springs Pediatric Dental, PLLCDripping Springs, TX$28K
Children's Dental Ranch of New Braunfels, PLLCNew Braunfels, TX$22K

Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.