Dental
Phoenix Pediatric Dental
Phoenix Pediatric Dental was paid $62K by Medicaid between Oct 2021 and Jan 2024, across 13 billing codes. Its largest line is D1120, dental cleaning, child — 25% of everything it billed.
33Billing provider infoPHOENIX PEDIATRIC DENTAL
PHOENIX, AZ 85015
PHOENIX, AZ 85015
33aNPI1437547775assigned 01/08/2015
33bProvider typePediatric Dentist
28Total paid$62K
24GClaims4,166
24DCodes billed13
24AFirst – last monthOct 2021 – Jan 2024
Compared with peers
Next to other Pediatric Dentist providers in Arizona
Rank by total paid#88 of 223
Median peer was paid$24K
This provider vs. median2.6×
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 | |
|---|---|---|---|
| 2021 | 646 | $8K | |
| 2022 | 2,354 | $36K | |
| 2023 | 953 | $15K | |
| 2024incomplete | 213 | $3K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 25% | 440 | 411 | $15K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 17% | 441 | 413 | $10K |
| D1208 | Topical application of fluoride, excluding varnish | 15% | 550 | 519 | $9K |
| D0230 | Intraoral - periapical each additional radiographic image | 14% | 1,045 | 519 | $9K |
| D0220 | Intraoral - periapical first radiographic image | 11% | 578 | 536 | $7K |
| D0272 | Bitewings - two radiographic images | 9.6% | 324 | 297 | $6K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 4.6% | 38 | 13 | $3K |
| D1110 | Prophylaxis - adult | 2.0% | 30 | 28 | $1K |
| D0274 | Bitewings - four radiographic images | 1.2% | 25 | 25 | $718.42 |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 13 | 13 | $505.32 |
| D0330 | Panoramic radiographic image | <1% | 15 | 14 | $226.82 |
| D1330 | 0% | 98 | 98 | $0.00 |
1 more codes
| D1999 | 0% | 569 | $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 officialPACHECO, LUZ (HUMAN RESOURCE)
| Provider | Location | Paid |
|---|---|---|
| Phoenix Pediatric Dental, LLC | Phoenix, AZ | $7.66M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.