Clinic
Pony Express Dental LLC
Pony Express Dental LLC was paid $4K by Medicaid between Jul 2021 and Jan 2022, across 6 billing codes. Its largest line is D0220, Intraoral - periapical first radiographic image — 55% of everything it billed.
33Billing provider infoPONY EXPRESS DENTAL LLC
EAGLE MOUNTAIN, UT 84005
EAGLE MOUNTAIN, UT 84005
33aNPI1609315480assigned 02/14/2017
33bProvider typeDental Clinic/Center
28Total paid$4K
24GClaims400
24DCodes billed6
24AFirst – last monthJul 2021 – Jan 2022
Compared with peers
Next to other Dental Clinic/Center providers in Utah
Rank by total paid#34 of 37
Median peer was paid$90K
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 | |
|---|---|---|---|
| 2021 | 332 | $3K | |
| 2022 | 68 | $352.29 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0220 | Intraoral - periapical first radiographic image | 55% | 114 | 107 | $2K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 39% | 12 | 12 | $1K |
| D1206 | Topical application of fluoride varnish | 2.9% | 58 | 56 | $104.83 |
| D1120 | Dental cleaning, childProphylaxis - child | 2.2% | 46 | 44 | $80.00 |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 157 | 74 | $35.00 |
| D0272 | Bitewings - two radiographic images | 0% | 13 | 13 | $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 officialTORNOW, MICHAEL (COO)
Parent organizationLAKE MOUNTAIN HEALTH, LLC
| Provider | Location | Paid |
|---|---|---|
| Cloud 9 Sleep Center | Farmington, NM | $790K |
| Sundance Dental Care of Bloomfield, LLC. | Bloomfield, NM | $556K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.