Dental
Pediatric Dentistry of Keller PLLC
Pediatric Dentistry of Keller PLLC was paid $760K by Medicaid between Nov 2020 and Dec 2024, across 20 billing codes. Its largest line is D0145, Oral evaluation for a patient under three years of age — 27% of everything it billed.
33Billing provider infoPEDIATRIC DENTISTRY OF KELLER PLLC
KELLER, TX 76248
KELLER, TX 76248
33aNPI1750934253assigned 07/23/2019
33bProvider typePediatric Dentist
28Total paid$760K
24GClaims29,205
24DCodes billed20
24AFirst – last monthNov 2020 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Texas
Rank by total paid#221 of 693
Median peer was paid$252K
This provider vs. median3.0×
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 | |
|---|---|---|---|
| 2020 | 341 | $6K | |
| 2021 | 4,391 | $117K | |
| 2022 | 7,549 | $191K | |
| 2023 | 9,143 | $235K | |
| 2024incomplete | 7,781 | $211K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0145 | Oral evaluation for a patient under three years of age | 27% | 1,504 | 1,474 | $202K |
| D1120 | Dental cleaning, childProphylaxis - child | 14% | 3,109 | 3,041 | $106K |
| D1351 | Sealant - per tooth | 13% | 4,218 | 707 | $99K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 9.2% | 2,575 | 2,508 | $70K |
| D1206 | Topical application of fluoride varnish | 6.0% | 3,286 | 3,214 | $45K |
| D0272 | Bitewings - two radiographic images | 5.0% | 1,716 | 1,682 | $38K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 4.4% | 354 | 206 | $33K |
| D0150 | Comprehensive oral evaluation - new or established patient | 4.3% | 985 | 965 | $32K |
| D0220 | Intraoral - periapical first radiographic image | 3.4% | 2,222 | 2,144 | $26K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 3.3% | 994 | 903 | $25K |
| D0230 | Intraoral - periapical each additional radiographic image | 2.8% | 2,032 | 1,946 | $22K |
| D1110 | Prophylaxis - adult | 2.6% | 368 | 366 | $19K |
8 more codes
| D0330 | Panoramic radiographic image | 2.2% | 306 | $16K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 1.3% | 71 | $10K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 87 | $6K |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 79 | $4K |
| D0274 | Bitewings - four radiographic images | <1% | 81 | $3K |
| D0140 | Limited oral evaluation - problem focused | <1% | 143 | $2K |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 14 | $191.10 |
| D0603 | 0% | 5,061 | $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 officialJOHNSON, JACOB (MEMBER)
| Provider | Location | Paid |
|---|---|---|
| Sanctum Health Partners, LLC | Carrollton, TX | $3.79M |
| Marble City Pharmacy INC | Sylacauga, AL | $31K |
| Next Generation Physical Therapy | Cabot, AR | $4K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.