Dental
White Mountain Dental
White Mountain Dental was paid $291K by Medicaid between Jan 2018 and Dec 2024, across 12 billing codes. Its largest line is D1110, Prophylaxis - adult — 26% of everything it billed.
33Billing provider infoWHITE MOUNTAIN DENTAL
ROCK SPRINGS, WY 82901
ROCK SPRINGS, WY 82901
33aNPI1497988356assigned 08/26/2009
33bProvider typeGeneral Practice Dentistry
28Total paid$291K
24GClaims8,667
24DCodes billed12
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in Wyoming
Rank by total paid#2 of 64
Median peer was paid$6K
This provider vs. median46×
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 | 1,426 | $54K | |
| 2019 | 1,137 | $42K | |
| 2020 | 628 | $19K | |
| 2021 | 783 | $19K | |
| 2022 | 1,670 | $51K | |
| 2023 | 1,851 | $58K | |
| 2024incomplete | 1,172 | $47K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 26% | 1,545 | 1,435 | $74K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 23% | 2,116 | 2,013 | $66K |
| D0274 | Bitewings - four radiographic images | 16% | 1,799 | 1,685 | $47K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 12% | 409 | 191 | $36K |
| D1206 | Topical application of fluoride varnish | 11% | 1,282 | 1,211 | $32K |
| D0220 | Intraoral - periapical first radiographic image | 3.5% | 677 | 623 | $10K |
| D0140 | Limited oral evaluation - problem focused | 2.6% | 190 | 177 | $8K |
| D1120 | Dental cleaning, childProphylaxis - child | 1.8% | 160 | 155 | $5K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 1.8% | 69 | 47 | $5K |
| D0230 | Intraoral - periapical each additional radiographic image | 1.5% | 316 | 62 | $5K |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.1% | 89 | 89 | $3K |
| D1330 | <1% | 15 | 15 | $170.66 |
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 officialCARLSON, TYLER (OWNER/DENTIST)