Dental
Kokomo Pediatric Dentistry, LLC
Kokomo Pediatric Dentistry, LLC was paid $5.53M by Medicaid between Jul 2018 and Dec 2024, across 33 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 21% of everything it billed.
33Billing provider infoKOKOMO PEDIATRIC DENTISTRY, LLC
KOKOMO, IN 46902
KOKOMO, IN 46902
33aNPI1063904100assigned 06/05/2018
33bProvider typePublic Health Dentist
28Total paid$5.53M
24GClaims166,666
24DCodes billed33
24AFirst – last monthJul 2018 – Dec 2024
Compared with peers
Next to other Public Health Dentist providers in Indiana
Rank by total paid#1 of 8
Median peer was paid$6K
This provider vs. median864×
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 | 9,324 | $60K | |
| 2019 | 26,357 | $983K | |
| 2020 | 23,284 | $805K | |
| 2021 | 26,480 | $895K | |
| 2022 | 26,632 | $843K | |
| 2023 | 28,801 | $911K | |
| 2024incomplete | 25,788 | $1.04M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 21% | 8,630 | 3,222 | $1.16M |
| D1120 | Dental cleaning, childProphylaxis - child | 8.8% | 16,666 | 15,535 | $488K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 7.8% | 7,106 | 4,719 | $429K |
| D1351 | Sealant - per tooth | 7.1% | 17,105 | 4,753 | $394K |
| D1206 | Topical application of fluoride varnish | 6.8% | 20,111 | 18,749 | $375K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 6.1% | 12,160 | 10,685 | $336K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 5.9% | 17,064 | 15,930 | $328K |
| D7140 | Extraction, erupted tooth or exposed root | 4.8% | 3,776 | 2,341 | $266K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 3.5% | 3,859 | 2,753 | $191K |
| D0230 | Intraoral - periapical each additional radiographic image | 3.0% | 21,053 | 7,271 | $164K |
| D1510 | 2.8% | 934 | 737 | $153K | |
| D1110 | Prophylaxis - adult | 2.6% | 3,366 | 3,144 | $142K |
21 more codes
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 2.5% | 1,394 | $138K |
| D2390 | 2.0% | 1,019 | $111K | |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.9% | 3,432 | $107K |
| D2331 | 1.8% | 1,198 | $100K | |
| D0272 | Bitewings - two radiographic images | 1.8% | 5,186 | $98K |
| D0330 | Panoramic radiographic image | 1.8% | 2,497 | $98K |
| D0220 | Intraoral - periapical first radiographic image | 1.6% | 9,070 | $90K |
| D2330 | 1.6% | 1,342 | $87K | |
| D0210 | Intraoral - complete series of radiographic images | 1.4% | 3,422 | $78K |
| D0140 | Limited oral evaluation - problem focused | 1.3% | 2,333 | $72K |
| D0274 | Bitewings - four radiographic images | <1% | 1,487 | $43K |
| D2332 | <1% | 315 | $30K | |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 301 | $22K |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 638 | $20K |
| D7111 | <1% | 173 | $12K | |
| D0273 | <1% | 14 | $305.25 | |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 64 | $134.34 |
| D1353 | 0% | 692 | $0.00 | |
| D1352 | 0% | 18 | $0.00 | |
| D9420 | 0% | 83 | $0.00 | |
| D3120 | 0% | 158 | $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 officialBEADLE, KEVIN (OWNER/DENTIST)