Clinic
Provo Downtown Dental, LLC
Provo Downtown Dental, LLC was paid $138K by Medicaid between Mar 2018 and Nov 2024, across 11 billing codes. Its largest line is D0120, dental checkup, returning patient — 29% of everything it billed.
33Billing provider infoPROVO DOWNTOWN DENTAL, LLC
PROVO, UT 84601
PROVO, UT 84601
33aNPI1851802813assigned 10/18/2017
33bProvider typeDental Clinic/Center
28Total paid$138K
24GClaims3,616
24DCodes billed11
24AFirst – last monthMar 2018 – Nov 2024
Compared with peers
Next to other Dental Clinic/Center providers in Utah
Rank by total paid#14 of 37
Median peer was paid$90K
This provider vs. median1.5×
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 | 236 | $6K | |
| 2019 | 12 | $46.84 | |
| 2020 | 52 | $290.14 | |
| 2021 | 582 | $20K | |
| 2022 | 2,061 | $93K | |
| 2023 | 514 | $15K | |
| 2024incomplete | 159 | $4K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 29% | 419 | 415 | $40K |
| D0150 | Comprehensive oral evaluation - new or established patient | 23% | 229 | 226 | $32K |
| D0220 | Intraoral - periapical first radiographic image | 22% | 616 | 549 | $30K |
| D0140 | Limited oral evaluation - problem focused | 11% | 244 | 240 | $16K |
| D1120 | Dental cleaning, childProphylaxis - child | 6.5% | 494 | 493 | $9K |
| D0330 | Panoramic radiographic image | 4.1% | 197 | 196 | $6K |
| D1110 | Prophylaxis - adult | 1.8% | 295 | 292 | $2K |
| D1206 | Topical application of fluoride varnish | 1.7% | 563 | 562 | $2K |
| D0274 | Bitewings - four radiographic images | <1% | 363 | 360 | $689.71 |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 129 | 79 | $631.14 |
| D0272 | Bitewings - two radiographic images | <1% | 67 | 67 | $161.34 |
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 officialCASTANEDA, KIM (OFFICE MANAGER)