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    OpenPayerNPI Medicare & MedicaidGranger Pediatric Dentistry
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    Granger Pediatric Dentistry — Billing Profile & Reimbursement Data

    NPI 1154637825 · West Valley City, UT · Dental Clinic/Center

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    Granger Pediatric Dentistry is a dental clinic/center provider located in West Valley City, Utah. This profile covers 0 Medicare and 23 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationGranger Pediatric Dentistry
    AddressGranger Pediatric Dentistry
    CityWest Valley City
    StateUT
    ZIP84119
    TaxonomyDental Clinic/Center
    NPI EnumeratedAugust 19, 2010

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$2.4M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

    Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

    23 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    D0120Periodic oral evaluation - established patient9,640$90$886.7K
    D1351Sealant - per tooth6,270$40$232.1K
    D0220Intraoral - periapical first radiographic image5,780$30$179.3K
    D1120Prophylaxis–child9,940$20$178.8K
    D2392Post 2 surface resin‑based composite2,480$60$153.8K
    D0272N/A5,110$30$148.3K
    D1206Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients10,630$10$85K
    D0150Comprehensive oral evaluation – new or established patient730$110$81.9K
    D2391Resin‑based composite – one surface, posterior1,420$60$80.9K
    D2930N/A880$80$69.8K

    Showing 1–10 of 23

    Medicaid: Competitive Analysis & Benchmarks

    How this provider's Medicaid billing volume and revenue compare to other Utah providers billing the same CPT/HCPCS codes.

    Full comparison — all codes billed, vs. Utah median

    23 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    D0120Periodic oral evaluation - established patient17470460$80$149.8K
    D1351Sealant - per tooth18190620$30$60.7K
    D2930N/A1770280$70$57.7K
    D0140Limited oral evaluation – problem focused68260140$120$55.8K
    D2150Amalgam - two surfaces, primary or permanent33220290$60$45K
    D2392Post 2 surface resin‑based composite4170170$80$39.4K
    D7140Extraction, erupted tooth or exposed root (elevation and/or forceps removal)23150170$60$35.9K
    D0220Intraoral - periapical first radiographic image20440470$20$32.8K
    D0150Comprehensive oral evaluation – new or established patient48420110$100$30.8K
    D1120Prophylaxis–child15420440$20$30.7K

    Showing 1–10 of 23

    Nearby Providers

    Other providers in the same ZIP code as Granger Pediatric Dentistry, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    University Of Utah Community Physicians GroupUTGeneral Practice Physician$0$36M
    Unified Fire Authority-salt LakeUTLand Ambulance$920.5K$14.6M
    C.n.s. CorporationUTHome Health Agency$0$13.6M
    West Valley CityUTAmbulance$202.1K$6.2M
    Granger Medical Clinic PCUTMulti-Specialty Clinic/Center$0$5.1M
    Unified Health Services LLCUTCommunity Based Hospice Care Agency$0$4.1M
    Community Nursing ServiceUTCommunity Based Hospice Care Agency$0$4.1M
    Hans PetersenUTPediatric Dentistry$0$1.6M
    Standard Optical CoUTOptometrist$0$1.5M
    Community Nursing ServiceUTHome Health Agency$0$970.4K

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Utah Providers
    0 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Utah Distribution
    Granger Pediatric Dentistry — 7 of 23 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Utah