Tri-Valley Dental P.C.

Tri-Valley Dental P.C. was paid $89K by Medicaid between Jan 2018 and Mar 2021, across 11 billing codes. Its largest line is D1206, Topical application of fluoride varnish — 34% of everything it billed.

33Billing provider infoTRI-VALLEY DENTAL P.C.
FREMONT, NE 68025

33aNPI1679653661assigned 10/16/2006

33bProvider typeGeneral Practice Dentistry

28Total paid$89K

24GClaims3,734

24DCodes billed11

24AFirst – last monthJan 2018 – Mar 2021

Compared with peers

Next to other General Practice Dentistry providers in Nebraska

Rank by total paid#55 of 201

Median peer was paid$21K

This provider vs. median4.2×

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
2018	1,269	$29K
2019	1,676	$45K
2020	649	$14K
2021	140	$2K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1206	Topical application of fluoride varnish	34%	1,476	1,393	$30K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	20%	857	856	$18K
D0210	Intraoral - complete series of radiographic images	13%	268	268	$12K
D1120	Dental cleaning, childProphylaxis - child	12%	404	404	$10K
D1110	Prophylaxis - adult	10%	283	283	$9K
D2391	Resin-based composite - one surface, posterior, primary or permanent	3.2%	51	25	$3K
D0150	Comprehensive oral evaluation - new or established patient	2.7%	117	117	$2K
D1999		2.2%	203	172	$2K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	2.0%	23	12	$2K
D0274	Bitewings - four radiographic images	<1%	37	37	$665.76
D0272	Bitewings - two radiographic images	<1%	15	15	$182.00

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 officialMAY, GARY (PRESIDENT)