Clinic
Bradshaw Mountain Family Dental Group PC
Bradshaw Mountain Family Dental Group PC was paid $5K by Medicaid between Jan 2018 and Nov 2022, across 9 billing codes. Its largest line is D0120, dental checkup, returning patient — 26% of everything it billed.
33Billing provider infoBRADSHAW MOUNTAIN FAMILY DENTAL GROUP PC
PRESCOTT VALLEY, AZ 86314
PRESCOTT VALLEY, AZ 86314
33aNPI1972773141assigned 03/04/2008
33bProvider typeDental Clinic/Center
28Total paid$5K
24GClaims1,921
24DCodes billed9
24AFirst – last monthJan 2018 – Nov 2022
Compared with peers
Next to other Dental Clinic/Center providers in Arizona
Rank by total paid#43 of 70
Median peer was paid$7K
This provider vs. median0.7×
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 | 200 | $4K | |
| 2019 | 343 | $494.24 | |
| 2020 | 681 | $216.64 | |
| 2021 | 200 | $0.00 | |
| 2022 | 497 | $0.00 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 26% | 389 | 387 | $1K |
| D1208 | Topical application of fluoride, excluding varnish | 25% | 404 | 402 | $1K |
| D1110 | Prophylaxis - adult | 18% | 277 | 277 | $828.67 |
| D0274 | Bitewings - four radiographic images | 12% | 207 | 207 | $561.84 |
| D0220 | Intraoral - periapical first radiographic image | 9.6% | 370 | 366 | $447.34 |
| D0230 | Intraoral - periapical each additional radiographic image | 6.4% | 150 | 150 | $296.67 |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 3.7% | 74 | 26 | $170.98 |
| D0601 | 0% | 38 | 38 | $0.00 | |
| D1120 | Dental cleaning, childProphylaxis - child | 0% | 12 | 12 | $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 officialFRAUSTO, DAVID (PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| Seasons Sage | Chino Valley, AZ | $7K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.