Dental
Petersburg Dental, INC.
Petersburg Dental, INC. was paid $79K by Medicaid between Feb 2018 and Nov 2024, across 9 billing codes. Its largest line is D0140, Limited oral evaluation - problem focused — 47% of everything it billed.
33Billing provider infoPETERSBURG DENTAL, INC.
PETERSBURG, AK 99833
PETERSBURG, AK 99833
33aNPI1932543345assigned 04/29/2013
33bProvider typeDentist
28Total paid$79K
24GClaims1,898
24DCodes billed9
24AFirst – last monthFeb 2018 – Nov 2024
Compared with peers
Next to other Dentist providers in Alaska
Rank by total paid#36 of 75
Median peer was paid$67K
This provider vs. median1.2×
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 | |
|---|---|---|---|
| 2018 | 91 | $5K | |
| 2019 | 174 | $7K | |
| 2020 | 239 | $8K | |
| 2021 | 357 | $14K | |
| 2022 | 386 | $17K | |
| 2023 | 440 | $18K | |
| 2024incomplete | 211 | $8K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0140 | Limited oral evaluation - problem focused | 47% | 691 | 567 | $37K |
| D0220 | Intraoral - periapical first radiographic image | 14% | 522 | 442 | $11K |
| D1110 | Prophylaxis - adult | 12% | 128 | 116 | $10K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 12% | 249 | 205 | $9K |
| D0230 | Intraoral - periapical each additional radiographic image | 6.0% | 193 | 141 | $5K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 3.9% | 25 | 13 | $3K |
| D0274 | Bitewings - four radiographic images | 3.8% | 62 | 50 | $3K |
| D1120 | Dental cleaning, childProphylaxis - child | 1.2% | 15 | 15 | $909.30 |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 13 | 12 | $306.35 |
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 officialLISTER, JAY (DDS/PRESIDENT)