Missoula Pediatric Dentistry PC

Missoula Pediatric Dentistry PC was paid $9.30M by Medicaid between Jan 2018 and Dec 2024, across 46 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 17% of everything it billed.

33Billing provider infoMISSOULA PEDIATRIC DENTISTRY PC
MISSOULA, MT 59801

33aNPI1942483524assigned 12/06/2007

33bProvider typeGeneral Practice Dentistry

28Total paid$9.30M

24GClaims246,384

24DCodes billed46

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other General Practice Dentistry providers in Montana

Rank by total paid#1 of 149

Median peer was paid$40K

This provider vs. median236×

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	42,375	$1.49M
2019	31,983	$1.27M
2020	31,906	$1.19M
2021	35,093	$1.24M
2022	38,144	$1.41M
2023	37,413	$1.52M
2024incomplete	29,470	$1.18M

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	17%	11,944	5,234	$1.59M
D1120	Dental cleaning, childProphylaxis - child	10%	26,238	25,130	$976K
D1206	Topical application of fluoride varnish	7.8%	34,447	32,389	$728K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	7.7%	26,615	25,335	$716K
D2930	Prefabricated stainless steel crown - primary tooth	5.8%	3,964	1,583	$541K
D2391	Resin-based composite - one surface, posterior, primary or permanent	4.8%	6,217	3,396	$449K
D1351	Sealant - per tooth	4.8%	14,336	3,689	$443K
D8670	Periodic orthodontic treatment visit	4.5%	5,205	4,755	$416K
D1110	Prophylaxis - adult	4.2%	7,159	6,689	$388K
D1310		4.1%	9,705	8,867	$377K
D0350		3.3%	16,864	14,787	$309K
D0330	Panoramic radiographic image	2.8%	4,468	4,284	$263K

34 more codes

D0272	Bitewings - two radiographic images	2.5%	10,092	$230K
D1330		2.2%	9,048	$207K
D7140	Extraction, erupted tooth or exposed root	2.2%	2,634	$201K
D9230	Inhalation of nitrous oxide / analgesia, anxiolysis	2.0%	5,769	$183K
D0603		1.9%	17,791	$181K
D0274	Bitewings - four radiographic images	1.7%	4,309	$156K
D2393	Resin-based composite - three surfaces, posterior, primary or permanent	1.3%	726	$126K
D0220	Intraoral - periapical first radiographic image	1.3%	6,794	$119K
D0425		1.2%	2,578	$107K
D0150	Comprehensive oral evaluation - new or established patient	1.1%	2,878	$104K
D0145	Oral evaluation for a patient under three years of age	1.0%	2,677	$94K
D9420		<1%	884	$80K
D0140	Limited oral evaluation - problem focused	<1%	2,073	$76K
D3220	Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction	<1%	735	$74K
D0230	Intraoral - periapical each additional radiographic image	<1%	4,598	$46K
D2932		<1%	200	$30K
D9310		<1%	454	$24K
D1353		<1%	517	$17K
D2332		<1%	103	$13K
D0240		<1%	501	$12K
D1515		<1%	32	$5K
D2330		<1%	76	$5K
D0601		<1%	522	$5K
D0460		<1%	153	$4K
D1516		<1%	15	$2K
D0340		<1%	40	$2K
D0602		<1%	189	$2K
D2331		<1%	16	$2K
D0171		<1%	227	$1K
D0470		<1%	40	$1K
D7111		<1%	16	$1K
D1354		<1%	35	$550.48
D1555		<1%	15	$546.83
D1999		<1%	2,485	$137.88

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 officialTIEDE, PAUL (BUSINESS MANAGER)