Clinic
Delta Dental of South Dakota Foundation
Delta Dental of South Dakota Foundation was paid $1.20M by Medicaid between Jan 2018 and Oct 2024, across 21 billing codes. Its largest line is D2391, Resin-based composite - one surface, posterior, primary or permanent — 22% of everything it billed.
33Billing provider infoDELTA DENTAL OF SOUTH DAKOTA FOUNDATION
PIERRE, SD 57501
PIERRE, SD 57501
33aNPI1023414125assigned 11/17/2014
33bProvider typeDental Clinic/Center
28Total paid$1.20M
24GClaims27,350
24DCodes billed21
24AFirst – last monthJan 2018 – Oct 2024
Compared with peers
Next to other Dental Clinic/Center providers in South Dakota
Rank by total paid#3 of 54
Median peer was paid$30K
This provider vs. median40×
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 | 3,982 | $172K | |
| 2019 | 4,087 | $179K | |
| 2020 | 1,537 | $64K | |
| 2021 | 2,871 | $111K | |
| 2022 | 6,689 | $298K | |
| 2023 | 4,476 | $172K | |
| 2024incomplete | 3,708 | $200K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 22% | 3,213 | 1,084 | $266K |
| D1351 | Sealant - per tooth | 20% | 6,948 | 1,492 | $243K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 16% | 1,901 | 811 | $191K |
| D1120 | Dental cleaning, childProphylaxis - child | 9.3% | 2,799 | 2,778 | $111K |
| D1206 | Topical application of fluoride varnish | 8.2% | 4,052 | 4,014 | $99K |
| D0150 | Comprehensive oral evaluation - new or established patient | 7.4% | 1,864 | 1,848 | $88K |
| D0272 | Bitewings - two radiographic images | 3.1% | 1,285 | 1,271 | $38K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 3.0% | 1,148 | 1,131 | $36K |
| D0274 | Bitewings - four radiographic images | 2.5% | 811 | 811 | $30K |
| D1110 | Prophylaxis - adult | 2.0% | 396 | 396 | $24K |
| D0220 | Intraoral - periapical first radiographic image | 1.3% | 877 | 858 | $16K |
| D0230 | Intraoral - periapical each additional radiographic image | 1.3% | 1,207 | 459 | $15K |
9 more codes
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 1.1% | 351 | $13K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 74 | $9K |
| D7111 | <1% | 74 | $5K | |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 102 | $4K |
| D1330 | <1% | 96 | $2K | |
| D2330 | <1% | 23 | $2K | |
| D1353 | <1% | 58 | $2K | |
| D3120 | <1% | 45 | $2K | |
| D0240 | <1% | 26 | $418.08 |
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 officialHALVERSON, CONNIE (VP OF PUBLIC BENEFIT)
| Provider | Location | Paid |
|---|---|---|
| Delta Dental of South Dakota Foundation | Pierre, SD | $1.00M |
| Delta Dental of South Dakota Foundation | Pierre, SD | $595K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.