Dental
Sdcaz LLC
Sdcaz LLC was paid $969K by Medicaid between Dec 2022 and Dec 2024, across 17 billing codes. Its largest line is D1120, dental cleaning, child — 17% of everything it billed.
33Billing provider infoSDCAZ LLC
PHOENIX, AZ 85042
PHOENIX, AZ 85042
33aNPI1447976261assigned 10/13/2022
33bProvider typePediatric Dentist
28Total paid$969K
24GClaims49,214
24DCodes billed17
24AFirst – last monthDec 2022 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Arizona
Rank by total paid#24 of 223
Median peer was paid$24K
This provider vs. median41×
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 | |
|---|---|---|---|
| 2022 | 877 | $16K | |
| 2023 | 23,382 | $499K | |
| 2024incomplete | 24,955 | $454K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 17% | 4,824 | 4,655 | $161K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 14% | 5,951 | 5,752 | $134K |
| D0230 | Intraoral - periapical each additional radiographic image | 12% | 12,972 | 5,933 | $116K |
| D1208 | Topical application of fluoride, excluding varnish | 12% | 6,992 | 6,758 | $112K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 8.5% | 1,129 | 747 | $82K |
| D0220 | Intraoral - periapical first radiographic image | 7.6% | 6,490 | 6,218 | $73K |
| D0274 | Bitewings - four radiographic images | 7.6% | 2,878 | 2,781 | $73K |
| D1110 | Prophylaxis - adult | 5.5% | 1,316 | 1,274 | $54K |
| D0272 | Bitewings - two radiographic images | 3.6% | 2,027 | 1,939 | $35K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 3.5% | 567 | 384 | $34K |
| D1353 | 2.5% | 1,552 | 563 | $24K | |
| D1351 | Sealant - per tooth | 2.5% | 1,216 | 464 | $24K |
5 more codes
| D0330 | Panoramic radiographic image | 1.8% | 477 | $18K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 1.1% | 496 | $10K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 1.0% | 124 | $10K |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 186 | $6K |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 17 | $1K |
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 officialWIETH, CASSANDRA (DIRECTOR OF PAYOR RELATIONS)
| Provider | Location | Paid |
|---|---|---|
| JMJ Practice Holdings, LLC | Nampa, ID | $1.09M |
| Nicholas Raklios, DDS, PLLC | Renton, WA | $171K |
| JMJ Practice Holdings, LLC | Nampa, ID | $73K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.