Clinic
Sam Bass Family Dentistry PLLC
Sam Bass Family Dentistry PLLC was paid $45K by Medicaid between Mar 2021 and Nov 2024, across 10 billing codes. Its largest line is D0230, Intraoral - periapical each additional radiographic image — 25% of everything it billed.
33Billing provider infoSAM BASS FAMILY DENTISTRY PLLC
ROUND ROCK, TX 78681
ROUND ROCK, TX 78681
33aNPI1063809820assigned 04/20/2015
33bProvider typeDental Clinic/Center
28Total paid$45K
24GClaims3,825
24DCodes billed10
24AFirst – last monthMar 2021 – Nov 2024
Compared with peers
Next to other Dental Clinic/Center providers in Texas
Rank by total paid#159 of 255
Median peer was paid$110K
This provider vs. median0.4×
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 | |
|---|---|---|---|
| 2021 | 1,157 | $14K | |
| 2022 | 1,154 | $13K | |
| 2023 | 952 | $11K | |
| 2024incomplete | 562 | $8K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0230 | Intraoral - periapical each additional radiographic image | 25% | 1,293 | 478 | $11K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 18% | 314 | 286 | $8K |
| D1208 | Topical application of fluoride, excluding varnish | 13% | 441 | 412 | $6K |
| D0220 | Intraoral - periapical first radiographic image | 12% | 536 | 492 | $5K |
| D0274 | Bitewings - four radiographic images | 12% | 194 | 178 | $5K |
| D1120 | Dental cleaning, childProphylaxis - child | 9.9% | 142 | 130 | $4K |
| D1110 | Prophylaxis - adult | 5.6% | 51 | 50 | $3K |
| D0350 | 4.7% | 180 | 165 | $2K | |
| D1999 | 0% | 35 | 30 | $0.00 | |
| D0602 | 0% | 639 | 612 | $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 officialGOVINDARAJAN, RUPA (OWNER)