Dental
Moses Lake Pediatric Dentistry
Moses Lake Pediatric Dentistry was paid $9.61M by Medicaid between Jan 2018 and Dec 2024, across 35 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 17% of everything it billed.
33Billing provider infoMOSES LAKE PEDIATRIC DENTISTRY
MOSES LAKE, WA 98837
MOSES LAKE, WA 98837
33aNPI1942657952assigned 05/19/2016
33bProvider typeDentist
28Total paid$9.61M
24GClaims300,444
24DCodes billed35
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Dentist providers in Washington
Rank by total paid#13 of 335
Median peer was paid$30K
This provider vs. median315×
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 | 31,859 | $866K | |
| 2019 | 30,706 | $919K | |
| 2020 | 39,314 | $1.19M | |
| 2021 | 46,622 | $1.37M | |
| 2022 | 47,382 | $1.36M | |
| 2023 | 48,429 | $1.94M | |
| 2024incomplete | 56,132 | $1.97M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 17% | 10,068 | 2,419 | $1.62M |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 9.8% | 32,935 | 32,888 | $940K |
| D2929 | 9.4% | 3,866 | 1,123 | $901K | |
| D1120 | Dental cleaning, childProphylaxis - child | 9.1% | 36,071 | 36,006 | $876K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 9.0% | 11,976 | 6,122 | $863K |
| D1206 | Topical application of fluoride varnish | 8.2% | 36,888 | 36,684 | $787K |
| D1351 | Sealant - per tooth | 5.7% | 22,951 | 6,203 | $546K |
| D9999 | Unspecified adjunctive procedure, by report | 5.0% | 15,846 | 15,791 | $479K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 4.3% | 6,994 | 4,040 | $418K |
| D7140 | Extraction, erupted tooth or exposed root | 3.6% | 6,031 | 3,264 | $347K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 3.0% | 13,341 | 12,742 | $290K |
| D0150 | Comprehensive oral evaluation - new or established patient | 3.0% | 6,786 | 6,753 | $286K |
23 more codes
| D9248 | 2.9% | 5,027 | $276K | |
| D0272 | Bitewings - two radiographic images | 2.4% | 22,404 | $227K |
| D0330 | Panoramic radiographic image | 1.9% | 4,460 | $180K |
| D0220 | Intraoral - periapical first radiographic image | 1.0% | 11,801 | $98K |
| D0140 | Limited oral evaluation - problem focused | 1.0% | 4,447 | $96K |
| D0240 | <1% | 7,864 | $67K | |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | <1% | 720 | $65K |
| D1999 | <1% | 5,635 | $65K | |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 19,247 | $45K |
| D1110 | Prophylaxis - adult | <1% | 891 | $40K |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 2,351 | $31K |
| D0274 | Bitewings - four radiographic images | <1% | 3,301 | $30K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 413 | $30K |
| D7111 | <1% | 107 | $3K | |
| D7960 | <1% | 30 | $3K | |
| D9630 | <1% | 34 | $2K | |
| D2331 | <1% | 19 | $1K | |
| D0190 | <1% | 31 | $306.00 | |
| D1330 | <1% | 31 | $220.49 | |
| D0602 | 0% | 44 | $0.00 | |
| D0603 | 0% | 7,789 | $0.00 | |
| D3120 | 0% | 27 | $0.00 | |
| D0601 | 0% | 18 | $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 officialCOX, STANLEY (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Little Big Kids Pediatric Dentistry | Ellensburg, WA | $763K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.