Objective: To examine trends and variations in billed and paid amounts for preventive dental procedures by race/ethnicity, age, and sex in Wisconsin dental Medicaid. Methods: We analyzed data from the 2001 to 2013 Wisconsin Medicaid claims database for preventive dental procedures for children and adults. Billed and paid amounts for preventive dental procedures were aggregated over a visit and adjusted for inflation based on the Medical Care Consumer Price Index produced by the Bureau of Labor Statistics for 2013. Quantile regression was used to examine the trends over time and the effect of patient demographics. Result: At the 50th and 75th percentiles, the overall billed amounts for preventive dental procedures were 84.97and 105.53, and the paid amounts were 35.80and 41.66, respectively. At the 75th percentile, there was a 2.24increaseperyearinthebilledamountanda 26.88 overall increase from 2001 to 2013. In the paid amount, there was a 1.34decreaseperyearforanoverall 16.07 decrease from 2001 to 2013. Billed and paid claims for racial/ethnic minority enrollees were 1to 3 higher per visit at the 75th percentile when compared with those of Whites. Regarding the billed: paid ratio, White, African American, and Hispanic enrollees had values of 50% to 52%, whereas American Indians had the lowest value at 47.7%. At the 75th percentile, children aged 10 to 19 y had significantly higher billed (26.73)andpaid( 9.92) amounts than did adults aged 20 to 69 y. Conclusion: The billed amount increased over time, and the paid amount decreased after adjustment for inflation. In addition, there was a wide gap between billed and paid amounts over time. Knowledge Transfer Statement: This study highlights clear differences between paid and billed amounts in Wisconsin dental Medicaid. The financial health of dental practices is dependent on appropriate reimbursement for dental services provided; thus, information of this nature could serve as a proxy performance measure for access to preventive dental care. Findings from this study could be used by policy makers and dental Medicaid program managers to develop outcome metrics to improve access to preventive dental services.