Managed care
Stone Ridge Dental INC.
Stone Ridge Dental INC. was paid $11K by Medicaid between Jan 2018 and Mar 2020, across 6 billing codes. Its largest line is D1110, Prophylaxis - adult — 68% of everything it billed.
33Billing provider infoSTONE RIDGE DENTAL INC.
SHELLEY, ID 83274
SHELLEY, ID 83274
33aNPI1558512277assigned 10/01/2008
33bProvider typePreferred Provider Organization
28Total paid$11K
24GClaims978
24DCodes billed6
24AFirst – last monthJan 2018 – Mar 2020
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 | 681 | $10K | |
| 2019 | 271 | $980.99 | |
| 2020 | 26 | $0.00 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 68% | 94 | 94 | $8K |
| D1120 | Dental cleaning, childProphylaxis - child | 12% | 45 | 45 | $1K |
| D1208 | Topical application of fluoride, excluding varnish | 12% | 356 | 356 | $1K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 8.0% | 345 | 345 | $898.80 |
| D0274 | Bitewings - four radiographic images | 0% | 107 | 107 | $0.00 |
| D0272 | Bitewings - two radiographic images | 0% | 31 | 31 | $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 officialCARPENTER, CURTIS (OWNER)