Clinic
Sandcreek Dental LLC
Sandcreek Dental LLC was paid $1.34M by Medicaid between Aug 2019 and Nov 2024, across 21 billing codes. Its largest line is D1110, Prophylaxis - adult — 16% of everything it billed.
33Billing provider infoSANDCREEK DENTAL LLC
TILLAMOOK, OR 97141
TILLAMOOK, OR 97141
33aNPI1952669657assigned 05/01/2012
33bProvider typeDental Clinic/Center
28Total paid$1.34M
24GClaims23,823
24DCodes billed21
24AFirst – last monthAug 2019 – Nov 2024
Compared with peers
Next to other Dental Clinic/Center providers in Oregon
Rank by total paid#10 of 39
Median peer was paid$86K
This provider vs. median16×
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 | |
|---|---|---|---|
| 2019 | 484 | $26K | |
| 2020 | 5,373 | $321K | |
| 2021 | 4,504 | $266K | |
| 2022 | 4,512 | $235K | |
| 2023 | 3,883 | $215K | |
| 2024incomplete | 5,067 | $273K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 16% | 2,795 | 2,703 | $220K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 14% | 3,717 | 3,605 | $193K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 12% | 893 | 610 | $164K |
| D0140 | Limited oral evaluation - problem focused | 10% | 2,215 | 2,074 | $138K |
| D1120 | Dental cleaning, childProphylaxis - child | 7.7% | 1,752 | 1,690 | $103K |
| D0220 | Intraoral - periapical first radiographic image | 6.3% | 3,520 | 3,321 | $84K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 5.5% | 575 | 365 | $73K |
| D0230 | Intraoral - periapical each additional radiographic image | 5.2% | 2,530 | 1,998 | $69K |
| D0274 | Bitewings - four radiographic images | 5.1% | 1,198 | 1,148 | $68K |
| D1206 | Topical application of fluoride varnish | 4.9% | 1,766 | 1,712 | $65K |
| D0150 | Comprehensive oral evaluation - new or established patient | 3.8% | 702 | 674 | $50K |
| D1208 | Topical application of fluoride, excluding varnish | 2.4% | 937 | 907 | $32K |
9 more codes
| D0210 | Intraoral - complete series of radiographic images | 1.4% | 187 | $19K |
| D0330 | Panoramic radiographic image | 1.3% | 244 | $17K |
| D0272 | Bitewings - two radiographic images | 1.2% | 417 | $16K |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 77 | $11K |
| D1354 | <1% | 179 | $5K | |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 19 | $4K |
| D2331 | <1% | 15 | $2K | |
| D0270 | <1% | 53 | $1K | |
| D1351 | Sealant - per tooth | <1% | 32 | $1K |
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 officialJAVADI, CYRUS (SOLE MEMBER)