Dental
Little Pearls Bothell LLC
Little Pearls Bothell LLC was paid $577K by Medicaid between Dec 2018 and Dec 2024, across 21 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 15% of everything it billed.
33Billing provider infoLITTLE PEARLS BOTHELL LLC
BOTHELL, WA 98012
BOTHELL, WA 98012
33aNPI1598272452assigned 01/01/2018
33bProvider typePublic Health Dentist
28Total paid$577K
24GClaims23,357
24DCodes billed21
24AFirst – last monthDec 2018 – Dec 2024
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 | 16 | $437.38 | |
| 2019 | 19 | $431.80 | |
| 2020 | 98 | $993.48 | |
| 2021 | 881 | $15K | |
| 2022 | 3,904 | $79K | |
| 2023 | 8,954 | $231K | |
| 2024incomplete | 9,485 | $251K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 15% | 1,218 | 586 | $86K |
| D1206 | Topical application of fluoride varnish | 14% | 3,782 | 3,515 | $80K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 13% | 2,717 | 2,563 | $77K |
| D1120 | Dental cleaning, childProphylaxis - child | 12% | 3,199 | 2,981 | $70K |
| D1351 | Sealant - per tooth | 8.2% | 2,057 | 592 | $47K |
| D0150 | Comprehensive oral evaluation - new or established patient | 6.6% | 1,061 | 957 | $38K |
| D1110 | Prophylaxis - adult | 4.6% | 676 | 634 | $27K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 4.6% | 450 | 264 | $27K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 3.3% | 818 | 685 | $19K |
| D9999 | Unspecified adjunctive procedure, by report | 3.2% | 623 | 585 | $18K |
| D0330 | Panoramic radiographic image | 2.7% | 504 | 468 | $16K |
| D0272 | Bitewings - two radiographic images | 2.5% | 1,644 | 1,553 | $14K |
9 more codes
| D7140 | Extraction, erupted tooth or exposed root | 2.2% | 254 | $13K |
| D0160 | 1.7% | 278 | $10K | |
| D0274 | Bitewings - four radiographic images | 1.6% | 1,038 | $9K |
| D0140 | Limited oral evaluation - problem focused | 1.6% | 442 | $9K |
| D0220 | Intraoral - periapical first radiographic image | 1.5% | 1,215 | $9K |
| D2930 | Prefabricated stainless steel crown - primary tooth | <1% | 30 | $5K |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 1,303 | $3K |
| D1999 | <1% | 30 | $10.00 | |
| D3120 | 0% | 18 | $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 officialLILLY, NANDITA (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Federal Way Dental LLC | Federal Way, WA | $211K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.