Clinic
Blacks Fork Dental, PC
Blacks Fork Dental, PC was paid $44K by Medicaid between May 2020 and Nov 2024, across 10 billing codes. Its largest line is D1206, Topical application of fluoride varnish — 35% of everything it billed.
33Billing provider infoBLACKS FORK DENTAL, PC
MT VIEW, WY 82939
MT VIEW, WY 82939
33aNPI1508322603assigned 02/13/2019
33bProvider typeDental Clinic/Center
28Total paid$44K
24GClaims1,864
24DCodes billed10
24AFirst – last monthMay 2020 – Nov 2024
Compared with peers
Next to other Dental Clinic/Center providers in Wyoming
Rank by total paid#5 of 18
Median peer was paid$7K
This provider vs. median6.8×
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 | 113 | $860.00 | |
| 2021 | 278 | $5K | |
| 2022 | 713 | $16K | |
| 2023 | 547 | $13K | |
| 2024incomplete | 213 | $9K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1206 | Topical application of fluoride varnish | 35% | 609 | 596 | $15K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 22% | 360 | 348 | $10K |
| D1120 | Dental cleaning, childProphylaxis - child | 11% | 132 | 131 | $5K |
| D0220 | Intraoral - periapical first radiographic image | 9.4% | 312 | 286 | $4K |
| D0274 | Bitewings - four radiographic images | 7.2% | 92 | 90 | $3K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 7.0% | 40 | 15 | $3K |
| D1110 | Prophylaxis - adult | 4.4% | 41 | 41 | $2K |
| D0230 | Intraoral - periapical each additional radiographic image | 3.9% | 187 | 70 | $2K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | <1% | 16 | 15 | $365.76 |
| D1999 | 0% | 75 | 60 | $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 officialLESTER, NATHAN (PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| Bear River Dental | Evanston, WY | $660K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.