Clinic
Pda Holdings West, LLC
Pda Holdings West, LLC was paid $175K by Medicaid between Jun 2023 and Dec 2024, across 18 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 16% of everything it billed.
33Billing provider infoPDA HOLDINGS WEST, LLC
PHOENIX, AZ 85031
PHOENIX, AZ 85031
33aNPI1760188098assigned 02/07/2023
33bProvider typeDental Clinic/Center
28Total paid$175K
24GClaims14,270
24DCodes billed18
24AFirst – last monthJun 2023 – Dec 2024
Compared with peers
Next to other Dental Clinic/Center providers in Arizona
Rank by total paid#15 of 70
Median peer was paid$7K
This provider vs. median25×
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 | |
|---|---|---|---|
| 2023 | 1,232 | $15K | |
| 2024incomplete | 13,038 | $160K |
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% | 788 | 509 | $29K |
| D1120 | Dental cleaning, childProphylaxis - child | 12% | 1,282 | 1,244 | $21K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 11% | 1,694 | 1,657 | $19K |
| D1206 | Topical application of fluoride varnish | 9.1% | 1,894 | 1,855 | $16K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 8.2% | 507 | 320 | $14K |
| D0274 | Bitewings - four radiographic images | 7.8% | 1,045 | 1,022 | $14K |
| D0220 | Intraoral - periapical first radiographic image | 7.0% | 2,141 | 2,071 | $12K |
| D1110 | Prophylaxis - adult | 6.1% | 539 | 531 | $11K |
| D0230 | Intraoral - periapical each additional radiographic image | 5.6% | 1,927 | 1,880 | $10K |
| D1351 | Sealant - per tooth | 5.1% | 965 | 345 | $9K |
| D0330 | Panoramic radiographic image | 3.2% | 253 | 252 | $6K |
| D0272 | Bitewings - two radiographic images | 2.8% | 587 | 568 | $5K |
6 more codes
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 2.1% | 302 | $4K |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.4% | 130 | $2K |
| D0140 | Limited oral evaluation - problem focused | 1.1% | 124 | $2K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 50 | $1K |
| D2930 | Prefabricated stainless steel crown - primary tooth | <1% | 15 | $740.13 |
| D0603 | 0% | 27 | $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 officialTARWATER, JERAMY (PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| Pda Holdco Chandler LLC | Chandler, AZ | $37K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.