Dental
Gray, Kali
Gray, Kali was paid $379.00 by Medicaid between Feb 2018 and Aug 2022, across 12 billing codes. Its largest line is D1120, dental cleaning, child — 53% of everything it billed.
33Billing provider infoGRAY, KALI
ELGIN, OR 97827
ELGIN, OR 97827
33aNPI1548675358assigned 07/01/2014
33bProvider typeDentist
28Total paid$379.00
24GClaims971
24DCodes billed12
24AFirst – last monthFeb 2018 – Aug 2022
Compared with peers
Next to other Dentist providers in Oregon
Rank by total paid#202 of 233
Median peer was paid$19K
This provider vs. median0.0×
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 | 318 | $59.00 | |
| 2019 | 462 | $320.00 | |
| 2020 | 55 | $0.00 | |
| 2021 | 124 | $0.00 | |
| 2022 | 12 | $0.00 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 53% | 138 | 137 | $200.00 |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 22% | 24 | 24 | $84.00 |
| D0150 | Comprehensive oral evaluation - new or established patient | 20% | 73 | 73 | $76.00 |
| D1206 | Topical application of fluoride varnish | 5.0% | 144 | 143 | $19.00 |
| D0220 | Intraoral - periapical first radiographic image | 0% | 107 | 106 | $0.00 |
| D1110 | Prophylaxis - adult | 0% | 78 | 78 | $0.00 |
| D0140 | Limited oral evaluation - problem focused | 0% | 25 | 24 | $0.00 |
| D1208 | Topical application of fluoride, excluding varnish | 0% | 107 | 107 | $0.00 |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 0% | 14 | 13 | $0.00 |
| D1330 | 0% | 218 | 218 | $0.00 | |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 0% | 15 | 12 | $0.00 |
| D0210 | Intraoral - complete series of radiographic images | 0% | 28 | 28 | $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.