Rocky Mountain Family Dental

Rocky Mountain Family Dental was paid $85K by Medicaid between Jan 2019 and Nov 2024, across 12 billing codes. Its largest line is D0120, dental checkup, returning patient — 29% of everything it billed.

33Billing provider infoROCKY MOUNTAIN FAMILY DENTAL
CODY, WY 82414

33aNPI1629483813assigned 06/25/2014

33bProvider typeDentist

28Total paid$85K

24GClaims2,687

24DCodes billed12

24AFirst – last monthJan 2019 – Nov 2024

Compared with peers

Next to other Dentist providers in Wyoming

Rank by total paid#9 of 40

Median peer was paid$14K

This provider vs. median6.2×

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
2019	103	$3K
2020	116	$4K
2021	236	$7K
2022	902	$26K
2023	882	$30K
2024incomplete	448	$16K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	29%	764	737	$25K
D1206	Topical application of fluoride varnish	26%	804	770	$22K
D1120	Dental cleaning, childProphylaxis - child	21%	515	499	$18K
D1110	Prophylaxis - adult	11%	192	183	$9K
D0274	Bitewings - four radiographic images	3.7%	99	93	$3K
D0150	Comprehensive oral evaluation - new or established patient	2.7%	70	69	$2K
D4999		2.5%	132	95	$2K
D2391	Resin-based composite - one surface, posterior, primary or permanent	1.8%	16	12	$2K
D1351	Sealant - per tooth	1.4%	41	12	$1K
D0330	Panoramic radiographic image	<1%	16	15	$760.50
D0220	Intraoral - periapical first radiographic image	<1%	25	24	$365.78
D0272	Bitewings - two radiographic images	<1%	13	13	$257.40

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 officialRECTOR, LACI (DENTIST)