Dental
Pda Holdco Chandler LLC
Pda Holdco Chandler LLC was paid $37K by Medicaid between Feb 2023 and Dec 2024, across 21 billing codes. Its largest line is D1120, dental cleaning, child — 17% of everything it billed.
33Billing provider infoPDA HOLDCO CHANDLER LLC
CHANDLER, AZ 85224
CHANDLER, AZ 85224
33aNPI1811449671assigned 10/27/2016
33bProvider typeDentist
28Total paid$37K
24GClaims15,877
24DCodes billed21
24AFirst – last monthFeb 2023 – Dec 2024
Compared with peers
Next to other Dentist providers in Arizona
Rank by total paid#98 of 468
Median peer was paid$686.85
This provider vs. median54×
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 | 6,526 | $11K | |
| 2024incomplete | 9,351 | $26K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 17% | 1,947 | 1,878 | $6K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 10% | 811 | 402 | $4K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 10% | 1,910 | 1,847 | $4K |
| D1206 | Topical application of fluoride varnish | 9.1% | 2,063 | 1,982 | $3K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 7.5% | 334 | 173 | $3K |
| D0230 | Intraoral - periapical each additional radiographic image | 7.2% | 2,234 | 2,147 | $3K |
| D0220 | Intraoral - periapical first radiographic image | 6.9% | 2,518 | 2,420 | $3K |
| D0272 | Bitewings - two radiographic images | 5.7% | 1,012 | 977 | $2K |
| D0274 | Bitewings - four radiographic images | 4.3% | 757 | 714 | $2K |
| D1110 | Prophylaxis - adult | 3.9% | 409 | 400 | $1K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 3.6% | 61 | 13 | $1K |
| D1351 | Sealant - per tooth | 3.4% | 358 | 97 | $1K |
9 more codes
| D7140 | Extraction, erupted tooth or exposed root | 2.6% | 80 | $961.98 |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.4% | 243 | $886.43 |
| D0330 | Panoramic radiographic image | 2.1% | 219 | $779.41 |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 1.2% | 345 | $459.02 |
| D0210 | Intraoral - complete series of radiographic images | 1.1% | 55 | $393.90 |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 80 | $266.39 |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 329 | $264.76 |
| D0140 | Limited oral evaluation - problem focused | <1% | 60 | $164.22 |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 52 | $30.13 |
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 Holdings West, LLC | Phoenix, AZ | $175K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.