Dental
Specialized Dental Services-Jefferson Mall, PLLC
Specialized Dental Services-Jefferson Mall, PLLC was paid $1.69M by Medicaid between Aug 2020 and Dec 2024, across 10 billing codes. Its largest line is D7210, Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth — 31% of everything it billed.
33Billing provider infoSPECIALIZED DENTAL SERVICES-JEFFERSON MALL, PLLC
LOUISVILLE, KY 40219
LOUISVILLE, KY 40219
33aNPI1033397914assigned 02/04/2008
33bProvider typeOral and Maxillofacial Surgery (Dentist)
28Total paid$1.69M
24GClaims17,461
24DCodes billed10
24AFirst – last monthAug 2020 – Dec 2024
Compared with peers
Next to other Oral and Maxillofacial Surgery (Dentist) providers in Kentucky
Rank by total paid#13 of 48
Median peer was paid$214K
This provider vs. median7.9×
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 | |
|---|---|---|---|
| 2020 | 1,243 | $111K | |
| 2021 | 4,447 | $362K | |
| 2022 | 5,207 | $453K | |
| 2023 | 3,537 | $387K | |
| 2024incomplete | 3,027 | $375K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 31% | 4,870 | 1,088 | $524K |
| D7240 | Removal of impacted tooth - completely bony | 28% | 2,120 | 756 | $475K |
| D9223 | Deep sedation/general anesthesia - each subsequent 15 minute increment | 17% | 3,347 | 1,633 | $285K |
| D9222 | 8.6% | 1,712 | 1,636 | $145K | |
| D0140 | Limited oral evaluation - problem focused | 6.4% | 2,616 | 2,523 | $109K |
| D0330 | Panoramic radiographic image | 5.4% | 1,665 | 1,617 | $90K |
| D9610 | 1.6% | 869 | 829 | $27K | |
| D7220 | 1.0% | 153 | 78 | $17K | |
| D7230 | <1% | 77 | 53 | $13K | |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 32 | 32 | $2K |
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 officialREIBEL, JEFFREY (CHIEF FINANCIAL OFFICER)