Dental
Holm, Keith
Holm, Keith was paid $110K by Medicaid between Jan 2018 and Dec 2024, across 25 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 22% of everything it billed.
33Billing provider infoHOLM, KEITH
LITCHFIELD PARK, AZ 85340
LITCHFIELD PARK, AZ 85340
33aNPI1730210980assigned 03/08/2007
33bProvider typeGeneral Practice Dentistry
28Total paid$110K
24GClaims52,619
24DCodes billed25
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in Arizona
Rank by total paid#77 of 530
Median peer was paid$920.17
This provider vs. median119×
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 | 22,368 | $108K | |
| 2019 | 8,748 | $0.00 | |
| 2020 | 4,650 | $37.54 | |
| 2021 | 3,420 | $2K | |
| 2022 | 3,893 | $0.00 | |
| 2023 | 4,945 | $0.00 | |
| 2024incomplete | 4,595 | $0.00 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 22% | 2,676 | 1,091 | $24K |
| D1120 | Dental cleaning, childProphylaxis - child | 12% | 5,799 | 5,692 | $14K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 9.1% | 510 | 192 | $10K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 8.1% | 611 | 343 | $9K |
| D1206 | Topical application of fluoride varnish | 7.4% | 5,453 | 5,334 | $8K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 7.3% | 6,313 | 6,214 | $8K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 5.9% | 491 | 179 | $6K |
| D0220 | Intraoral - periapical first radiographic image | 4.5% | 7,770 | 7,441 | $5K |
| D0272 | Bitewings - two radiographic images | 4.5% | 4,264 | 4,147 | $5K |
| D0230 | Intraoral - periapical each additional radiographic image | 3.7% | 7,134 | 6,839 | $4K |
| D0150 | Comprehensive oral evaluation - new or established patient | 3.7% | 999 | 978 | $4K |
| D1110 | Prophylaxis - adult | 3.6% | 1,951 | 1,900 | $4K |
13 more codes
| D0274 | Bitewings - four radiographic images | 2.9% | 2,647 | $3K |
| D7140 | Extraction, erupted tooth or exposed root | 2.0% | 205 | $2K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 1.2% | 201 | $1K |
| D0330 | Panoramic radiographic image | <1% | 822 | $729.39 |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | <1% | 304 | $720.16 |
| D0140 | Limited oral evaluation - problem focused | <1% | 389 | $623.09 |
| D1351 | Sealant - per tooth | <1% | 216 | $318.55 |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 33 | $89.88 |
| D0210 | Intraoral - complete series of radiographic images | <1% | 303 | $47.00 |
| D0601 | 0% | 573 | $0.00 | |
| D0602 | 0% | 522 | $0.00 | |
| D0603 | 0% | 365 | $0.00 | |
| D1208 | Topical application of fluoride, excluding varnish | 0% | 2,068 | $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.