Clinic
Star Valley Dental 1 LLC
Star Valley Dental 1 LLC was paid $18K by Medicaid between May 2020 and Apr 2024, across 5 billing codes. Its largest line is D0120, dental checkup, returning patient — 61% of everything it billed.
33Billing provider infoSTAR VALLEY DENTAL 1 LLC
AFTON, WY 83110
AFTON, WY 83110
33aNPI1497394068assigned 12/31/2019
33bProvider typeDental Clinic/Center
28Total paid$18K
24GClaims577
24DCodes billed5
24AFirst – last monthMay 2020 – Apr 2024
Compared with peers
Next to other Dental Clinic/Center providers in Wyoming
Rank by total paid#6 of 18
Median peer was paid$7K
This provider vs. median2.7×
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 | |
|---|---|---|---|
| 2020 | 164 | $5K | |
| 2021 | 149 | $5K | |
| 2022 | 98 | $3K | |
| 2023 | 106 | $3K | |
| 2024incomplete | 60 | $2K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 61% | 360 | 338 | $11K |
| D1120 | Dental cleaning, childProphylaxis - child | 19% | 104 | 95 | $3K |
| D1110 | Prophylaxis - adult | 11% | 44 | 41 | $2K |
| D1206 | Topical application of fluoride varnish | 6.3% | 33 | 32 | $1K |
| D1208 | Topical application of fluoride, excluding varnish | 3.3% | 36 | 29 | $585.08 |
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 officialHOKANSON, DAVID (OWNER)