Dental
Ellisville Family Dental Center PA
Ellisville Family Dental Center PA was paid $591K by Medicaid between Jul 2018 and Nov 2024, across 13 billing codes. Its largest line is D1120, dental cleaning, child — 23% of everything it billed.
33Billing provider infoELLISVILLE FAMILY DENTAL CENTER PA
ELLISVILLE, MS 39437
ELLISVILLE, MS 39437
33aNPI1033269840assigned 01/12/2007
33bProvider typeGeneral Practice Dentistry
28Total paid$591K
24GClaims20,349
24DCodes billed13
24AFirst – last monthJul 2018 – Nov 2024
Compared with peers
Next to other General Practice Dentistry providers in Mississippi
Rank by total paid#57 of 379
Median peer was paid$78K
This provider vs. median7.6×
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 | 3,774 | $33K | |
| 2019 | 2,539 | $76K | |
| 2020 | 1,738 | $51K | |
| 2021 | 2,440 | $81K | |
| 2022 | 4,020 | $157K | |
| 2023 | 3,530 | $114K | |
| 2024incomplete | 2,308 | $79K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 23% | 4,892 | 4,329 | $133K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 17% | 3,671 | 3,529 | $102K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 15% | 853 | 580 | $92K |
| D1208 | Topical application of fluoride, excluding varnish | 13% | 4,782 | 4,245 | $74K |
| D0330 | Panoramic radiographic image | 10% | 1,497 | 1,244 | $61K |
| D0274 | Bitewings - four radiographic images | 5.3% | 1,301 | 1,068 | $31K |
| D0140 | Limited oral evaluation - problem focused | 5.2% | 1,182 | 794 | $31K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 4.9% | 354 | 236 | $29K |
| D0150 | Comprehensive oral evaluation - new or established patient | 4.1% | 1,175 | 745 | $24K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 1.4% | 57 | 40 | $8K |
| D0210 | Intraoral - complete series of radiographic images | <1% | 140 | 42 | $2K |
| D1351 | Sealant - per tooth | <1% | 384 | 14 | $1K |
1 more codes
| D0220 | Intraoral - periapical first radiographic image | <1% | 61 | $871.36 |
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 officialSURBER, STEPHEN (OWNER)