Clinic
Dental and Braces Mesa LLC
Dental and Braces Mesa LLC was paid $10K by Medicaid between Jul 2022 and Oct 2024, across 7 billing codes. Its largest line is D0220, Intraoral - periapical first radiographic image — 38% of everything it billed.
33Billing provider infoDENTAL AND BRACES MESA LLC
MESA, AZ 85204
MESA, AZ 85204
33aNPI1659835932assigned 01/30/2019
33bProvider typeHealth Service Clinic/Center
28Total paid$10K
24GClaims1,038
24DCodes billed7
24AFirst – last monthJul 2022 – Oct 2024
Compared with peers
Next to other Health Service Clinic/Center providers in Arizona
Rank by total paid#20 of 24
Median peer was paid$170K
This provider vs. median0.1×
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 | |
|---|---|---|---|
| 2022 | 160 | $4K | |
| 2023 | 196 | $3K | |
| 2024incomplete | 682 | $3K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0220 | Intraoral - periapical first radiographic image | 38% | 538 | 526 | $4K |
| D0150 | Comprehensive oral evaluation - new or established patient | 30% | 177 | 173 | $3K |
| D0330 | Panoramic radiographic image | 16% | 97 | 97 | $2K |
| D0274 | Bitewings - four radiographic images | 13% | 133 | 131 | $1K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 2.8% | 14 | 14 | $286.22 |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 0% | 22 | 14 | $0.00 |
| D1110 | Prophylaxis - adult | 0% | 57 | 57 | $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 officialRAMOS, LIZ (MANAGER)