Dental
Peoria Dental Center Group, LLC
Peoria Dental Center Group, LLC was paid $17K by Medicaid between Jan 2018 and Aug 2024, across 12 billing codes. Its largest line is D0140, Limited oral evaluation - problem focused — 27% of everything it billed.
33Billing provider infoPEORIA DENTAL CENTER GROUP, LLC
PEORIA, AZ 85345
PEORIA, AZ 85345
33aNPI1760756209assigned 03/01/2012
33bProvider typeGeneral Practice Dentistry
28Total paid$17K
24GClaims4,770
24DCodes billed12
24AFirst – last monthJan 2018 – Aug 2024
Compared with peers
Next to other General Practice Dentistry providers in Arizona
Rank by total paid#143 of 530
Median peer was paid$920.17
This provider vs. median19×
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 | 955 | $0.00 | |
| 2019 | 739 | $2K | |
| 2020 | 482 | $781.65 | |
| 2021 | 719 | $2K | |
| 2022 | 739 | $4K | |
| 2023 | 746 | $7K | |
| 2024incomplete | 390 | $2K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0140 | Limited oral evaluation - problem focused | 27% | 972 | 905 | $5K |
| D0220 | Intraoral - periapical first radiographic image | 22% | 2,057 | 1,889 | $4K |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 18% | 70 | 31 | $3K |
| D0274 | Bitewings - four radiographic images | 11% | 312 | 308 | $2K |
| D0230 | Intraoral - periapical each additional radiographic image | 7.6% | 834 | 727 | $1K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 5.3% | 230 | 228 | $896.48 |
| D1110 | Prophylaxis - adult | 3.5% | 82 | 80 | $604.15 |
| D1206 | Topical application of fluoride varnish | 1.9% | 124 | 122 | $322.14 |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.7% | 13 | 13 | $291.52 |
| D1120 | Dental cleaning, childProphylaxis - child | 1.6% | 51 | 50 | $277.76 |
| D0330 | Panoramic radiographic image | 1.1% | 12 | 12 | $184.54 |
| D2950 | 0% | 13 | 12 | $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 officialSALIM, RASOUL (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Hermosa Dental and Orthodontics Group LLC | Phoenix, AZ | $7K |
| Azona Company INC | Chandler, AZ | $214.68 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.