Dental
Grayson Pediatric Dentistry, P.C.
Grayson Pediatric Dentistry, P.C. was paid $2.01M by Medicaid between Jan 2018 and Dec 2024, across 20 billing codes. Its largest line is D1120, dental cleaning, child — 17% of everything it billed.
33Billing provider infoGRAYSON PEDIATRIC DENTISTRY, P.C.
GRAYSON, GA 30017
GRAYSON, GA 30017
33aNPI1598067993assigned 11/17/2010
33bProvider typePediatric Dentist
28Total paid$2.01M
24GClaims107,606
24DCodes billed20
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Georgia
Rank by total paid#7 of 38
Median peer was paid$58K
This provider vs. median35×
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 | 15,423 | $328K | |
| 2019 | 13,785 | $297K | |
| 2020 | 11,772 | $224K | |
| 2021 | 12,548 | $198K | |
| 2022 | 17,032 | $287K | |
| 2023 | 21,155 | $387K | |
| 2024incomplete | 15,891 | $292K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 17% | 13,237 | 13,124 | $346K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 12% | 13,265 | 13,175 | $244K |
| D1351 | Sealant - per tooth | 10% | 8,855 | 3,430 | $207K |
| D1208 | Topical application of fluoride, excluding varnish | 9.0% | 13,132 | 13,012 | $181K |
| D0220 | Intraoral - periapical first radiographic image | 8.0% | 14,323 | 14,188 | $162K |
| D0272 | Bitewings - two radiographic images | 7.0% | 7,884 | 7,828 | $141K |
| D0274 | Bitewings - four radiographic images | 7.0% | 5,181 | 5,146 | $141K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 6.1% | 1,709 | 1,036 | $122K |
| D0230 | Intraoral - periapical each additional radiographic image | 5.9% | 14,144 | 13,971 | $120K |
| D0150 | Comprehensive oral evaluation - new or established patient | 4.2% | 3,098 | 3,055 | $84K |
| D1110 | Prophylaxis - adult | 3.9% | 3,065 | 3,031 | $78K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 2.4% | 842 | 537 | $49K |
8 more codes
| D9920 | 1.7% | 895 | $34K | |
| D0330 | Panoramic radiographic image | 1.6% | 910 | $32K |
| D1206 | Topical application of fluoride varnish | 1.4% | 1,526 | $28K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 1.1% | 1,259 | $21K |
| D0210 | Intraoral - complete series of radiographic images | <1% | 837 | $19K |
| D0140 | Limited oral evaluation - problem focused | <1% | 105 | $2K |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 20 | $1K |
| D1999 | <1% | 3,319 | $1.86 |
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 officialPONUGOTI, ASHA YAMINI (OWNER)