Dental
Higley Village Kidtastic, LLC
Higley Village Kidtastic, LLC was paid $67K by Medicaid between Jan 2018 and Jun 2020, across 19 billing codes. Its largest line is D1120, dental cleaning, child — 30% of everything it billed.
33Billing provider infoHIGLEY VILLAGE KIDTASTIC, LLC
GILBERT, AZ 85297
GILBERT, AZ 85297
33aNPI1447598495assigned 01/25/2013
33bProvider typePediatric Dentist
28Total paid$67K
24GClaims10,648
24DCodes billed19
24AFirst – last monthJan 2018 – Jun 2020
Compared with peers
Next to other Pediatric Dentist providers in Arizona
Rank by total paid#85 of 223
Median peer was paid$24K
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 | 3,647 | $24K | |
| 2019 | 5,340 | $32K | |
| 2020 | 1,661 | $12K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 30% | 2,005 | 1,946 | $20K |
| D1206 | Topical application of fluoride varnish | 17% | 2,195 | 2,130 | $11K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 15% | 1,692 | 1,650 | $10K |
| D0230 | Intraoral - periapical each additional radiographic image | 7.3% | 971 | 649 | $5K |
| D0272 | Bitewings - two radiographic images | 6.3% | 835 | 806 | $4K |
| D0220 | Intraoral - periapical first radiographic image | 4.8% | 936 | 889 | $3K |
| D0274 | Bitewings - four radiographic images | 3.8% | 355 | 348 | $3K |
| D0150 | Comprehensive oral evaluation - new or established patient | 3.7% | 154 | 153 | $2K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 3.7% | 85 | 38 | $2K |
| D1110 | Prophylaxis - adult | 2.0% | 76 | 75 | $1K |
| D1351 | Sealant - per tooth | 1.9% | 202 | 64 | $1K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 1.6% | 197 | 180 | $1K |
7 more codes
| D0210 | Intraoral - complete series of radiographic images | 1.5% | 16 | $984.75 |
| D0240 | 1.1% | 100 | $723.94 | |
| D1354 | <1% | 86 | $292.78 | |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 20 | $212.77 |
| D0330 | Panoramic radiographic image | <1% | 30 | $150.16 |
| D0140 | Limited oral evaluation - problem focused | <1% | 13 | $146.44 |
| D0431 | 0% | 680 | $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 officialJOHNSON, JAIME (CONTROLLER)
| Provider | Location | Paid |
|---|---|---|
| Sun Valley Pediatric Dentistry, PLLC | Avondale, AZ | $267K |
| Fiesta Kidtastic, LLC | Mesa, AZ | $21K |
| Santan Kidtastic LLC | San Tan Valley, AZ | $6K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.