Dental
Big Sky Pediatric Dentistry PLLC
Big Sky Pediatric Dentistry PLLC was paid $105K by Medicaid between Oct 2024 and Dec 2024, across 23 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 16% of everything it billed.
33Billing provider infoBIG SKY PEDIATRIC DENTISTRY PLLC
KALISPELL, MT 59901
KALISPELL, MT 59901
33aNPI1730921289assigned 06/06/2024
33bProvider typePediatric Dentist
28Total paid$105K
24GClaims3,749
24DCodes billed23
24AFirst – last monthOct 2024 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Montana
Rank by total paid#20 of 25
Median peer was paid$1.14M
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 | |
|---|---|---|---|
| 2024incomplete | 3,749 | $105K |
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 | 16% | 160 | 79 | $17K |
| D1120 | Dental cleaning, childProphylaxis - child | 16% | 481 | 396 | $16K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 13% | 635 | 508 | $13K |
| D1206 | Topical application of fluoride varnish | 10% | 605 | 478 | $11K |
| D1351 | Sealant - per tooth | 8.0% | 293 | 89 | $8K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 6.4% | 54 | 13 | $7K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 3.7% | 126 | 107 | $4K |
| D1310 | 3.4% | 155 | 125 | $4K | |
| D0240 | 3.3% | 174 | 144 | $3K | |
| D1110 | Prophylaxis - adult | 3.0% | 145 | 99 | $3K |
| D0220 | Intraoral - periapical first radiographic image | 3.0% | 201 | 165 | $3K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 2.5% | 34 | 18 | $3K |
11 more codes
| D0272 | Bitewings - two radiographic images | 2.4% | 114 | $2K |
| D1330 | 2.0% | 155 | $2K | |
| D0140 | Limited oral evaluation - problem focused | 1.7% | 48 | $2K |
| D7140 | Extraction, erupted tooth or exposed root | 1.6% | 31 | $2K |
| D1353 | 1.0% | 55 | $1K | |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 112 | $1K |
| D0425 | <1% | 47 | $938.56 | |
| D0274 | Bitewings - four radiographic images | <1% | 54 | $768.38 |
| D0330 | Panoramic radiographic image | <1% | 15 | $736.68 |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 27 | $705.60 |
| D0601 | <1% | 28 | $198.40 |
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 officialDAWSON, GABRIEL (MANAGER)