Dental
Pediatric Smiles
Pediatric Smiles was paid $5.22M by Medicaid between Jan 2018 and Dec 2024, across 26 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 15% of everything it billed.
33Billing provider infoPEDIATRIC SMILES
BESSEMER, AL 35022
BESSEMER, AL 35022
33aNPI1003136615assigned 06/04/2010
33bProvider typePediatric Dentist
28Total paid$5.22M
24GClaims225,689
24DCodes billed26
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Alabama
Rank by total paid#17 of 111
Median peer was paid$708K
This provider vs. median7.4×
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 | 25,384 | $597K | |
| 2019 | 29,890 | $645K | |
| 2020 | 29,234 | $628K | |
| 2021 | 35,203 | $831K | |
| 2022 | 37,051 | $815K | |
| 2023 | 37,611 | $863K | |
| 2024incomplete | 31,316 | $839K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 15% | 14,460 | 1,929 | $777K |
| D1120 | Dental cleaning, childProphylaxis - child | 14% | 30,917 | 27,938 | $730K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 11% | 33,446 | 30,170 | $580K |
| D1208 | Topical application of fluoride, excluding varnish | 8.9% | 34,973 | 31,270 | $462K |
| D7140 | Extraction, erupted tooth or exposed root | 6.8% | 10,326 | 3,302 | $357K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 6.3% | 6,831 | 3,193 | $329K |
| D1999 | 5.4% | 16,884 | 14,259 | $282K | |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 5.4% | 4,655 | 2,374 | $282K |
| D1110 | Prophylaxis - adult | 4.3% | 6,903 | 6,155 | $224K |
| D0272 | Bitewings - two radiographic images | 3.5% | 12,128 | 10,440 | $180K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 3.3% | 9,901 | 8,383 | $174K |
| D0140 | Limited oral evaluation - problem focused | 2.8% | 6,447 | 5,548 | $148K |
14 more codes
| D0330 | Panoramic radiographic image | 2.6% | 3,560 | $133K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.1% | 5,008 | $107K |
| D1206 | Topical application of fluoride varnish | 1.9% | 4,350 | $100K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 1.8% | 2,026 | $92K |
| D0220 | Intraoral - periapical first radiographic image | 1.3% | 8,123 | $67K |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 8,512 | $49K |
| D0274 | Bitewings - four radiographic images | <1% | 2,344 | $47K |
| D2330 | <1% | 1,115 | $38K | |
| D1351 | Sealant - per tooth | <1% | 1,368 | $26K |
| D2331 | <1% | 351 | $16K | |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 466 | $8K |
| D0210 | Intraoral - complete series of radiographic images | <1% | 252 | $6K |
| D3120 | <1% | 84 | $336.00 | |
| D9420 | 0% | 259 | $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 officialJARMAN GATREY, TABITHA (OWNER/DENTIST)