Dental
Westover Hills Pediatric Dentistry
Westover Hills Pediatric Dentistry was paid $3.82M by Medicaid between Oct 2018 and Dec 2024, across 24 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 19% of everything it billed.
33Billing provider infoWESTOVER HILLS PEDIATRIC DENTISTRY
SAN ANTONIO, TX 78251
SAN ANTONIO, TX 78251
33aNPI1699929414assigned 11/06/2008
33bProvider typePediatric Dentist
28Total paid$3.82M
24GClaims121,038
24DCodes billed24
24AFirst – last monthOct 2018 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Texas
Rank by total paid#46 of 693
Median peer was paid$252K
This provider vs. median15×
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 | 53 | $1K | |
| 2019 | 24 | $787.20 | |
| 2020 | 3,310 | $113K | |
| 2021 | 29,055 | $954K | |
| 2022 | 27,078 | $911K | |
| 2023 | 29,212 | $922K | |
| 2024incomplete | 32,306 | $914K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 19% | 5,269 | 1,150 | $724K |
| D0145 | Oral evaluation for a patient under three years of age | 17% | 4,654 | 4,625 | $645K |
| D1120 | Dental cleaning, childProphylaxis - child | 11% | 12,111 | 12,009 | $436K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 11% | 14,846 | 14,717 | $421K |
| D1351 | Sealant - per tooth | 11% | 15,009 | 2,299 | $412K |
| D1208 | Topical application of fluoride, excluding varnish | 4.8% | 12,540 | 12,446 | $181K |
| D0210 | Intraoral - complete series of radiographic images | 4.7% | 2,620 | 2,603 | $179K |
| D1110 | Prophylaxis - adult | 4.6% | 3,289 | 3,270 | $177K |
| D0272 | Bitewings - two radiographic images | 4.2% | 7,047 | 6,965 | $160K |
| D0274 | Bitewings - four radiographic images | 2.1% | 2,380 | 2,371 | $80K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 1.9% | 930 | 476 | $72K |
| D0220 | Intraoral - periapical first radiographic image | 1.9% | 6,841 | 6,737 | $72K |
12 more codes
| D0230 | Intraoral - periapical each additional radiographic image | 1.4% | 5,567 | $52K |
| D1206 | Topical application of fluoride varnish | 1.3% | 3,500 | $50K |
| D9248 | <1% | 325 | $38K | |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 1,028 | $35K |
| D9420 | <1% | 831 | $28K | |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 246 | $14K |
| D0330 | Panoramic radiographic image | <1% | 295 | $13K |
| D0140 | Limited oral evaluation - problem focused | <1% | 696 | $13K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 133 | $10K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | <1% | 166 | $4K |
| D0603 | 0% | 12,035 | $0.00 | |
| D0602 | 0% | 8,680 | $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 officialDE LA GARZA, RICARDO (PEDIATRIC DENTIST)