Portneuf Valley Dental

Portneuf Valley Dental was paid $10K by Medicaid between Aug 2022 and Nov 2022, across 8 billing codes. Its largest line is D1110, Prophylaxis - adult — 56% of everything it billed.

33Billing provider infoPORTNEUF VALLEY DENTAL
POCATELLO, ID 83201

33aNPI1770127565assigned 11/05/2019

33bProvider typeDental Clinic/Center

28Total paid$10K

24GClaims477

24DCodes billed8

24AFirst – last monthAug 2022 – Nov 2022

Compared with peers

Next to other Dental Clinic/Center providers in Idaho

Rank by total paid#31 of 39

Median peer was paid$56K

This provider vs. median0.2×

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
2022	477	$10K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1110	Prophylaxis - adult	56%	100	100	$6K
D0210	Intraoral - complete series of radiographic images	25%	28	28	$3K
D0330	Panoramic radiographic image	12%	28	28	$1K
D0150	Comprehensive oral evaluation - new or established patient	4.6%	82	82	$468.98
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	1.5%	77	77	$151.38
D0274	Bitewings - four radiographic images	<1%	33	33	$49.42
D0230	Intraoral - periapical each additional radiographic image	0%	70	37	$0.00
D0220	Intraoral - periapical first radiographic image	0%	59	58	$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 officialBIRD, JAYSON (CEO/OWNER)