Solomon Pediatric Dental PLLC

Solomon Pediatric Dental PLLC was paid $108K by Medicaid between Jan 2018 and Sep 2021, across 19 billing codes. Its largest line is D1120, dental cleaning, child — 32% of everything it billed.

33Billing provider infoSOLOMON PEDIATRIC DENTAL PLLC
GLENDALE, AZ 85306

33aNPI1548540024assigned 08/28/2011

33bProvider typePediatric Dentist

28Total paid$108K

24GClaims8,295

24DCodes billed19

24AFirst – last monthJan 2018 – Sep 2021

Compared with peers

Next to other Pediatric Dentist providers in Arizona

Rank by total paid#70 of 223

Median peer was paid$24K

This provider vs. median4.6×

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	4,385	$37K
2019	1,818	$32K
2020	725	$14K
2021	1,367	$26K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1120	Dental cleaning, childProphylaxis - child	32%	1,379	1,332	$35K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	17%	1,128	1,096	$19K
D1206	Topical application of fluoride varnish	17%	1,443	1,401	$19K
D0220	Intraoral - periapical first radiographic image	11%	1,343	1,314	$11K
D0230	Intraoral - periapical each additional radiographic image	8.9%	1,601	1,146	$10K
D0272	Bitewings - two radiographic images	7.9%	722	708	$9K
D2930	Prefabricated stainless steel crown - primary tooth	1.2%	86	38	$1K
D0210	Intraoral - complete series of radiographic images	1.0%	59	59	$1K
D0150	Comprehensive oral evaluation - new or established patient	<1%	69	68	$793.59
D7140	Extraction, erupted tooth or exposed root	<1%	73	39	$689.67
D3220	Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction	<1%	62	28	$632.48
D2150	Silver amalgam - two surfaces, primary or permanent	<1%	64	35	$517.98

7 more codes

D2140		<1%	25	$375.96
D0140	Limited oral evaluation - problem focused	<1%	45	$339.83
D1351	Sealant - per tooth	<1%	82	$337.74
D9230	Inhalation of nitrous oxide / analgesia, anxiolysis	<1%	74	$164.23
D0330	Panoramic radiographic image	<1%	13	$97.48
D0274	Bitewings - four radiographic images	0%	13	$0.00
D1110	Prophylaxis - adult	0%	14	$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 officialSOLOMON, RAYMOND (PEDIATRIC DENTIST)