Clinic
Bolen Family Dentistry P.C.
Bolen Family Dentistry P.C. was paid $31K by Medicaid between Jan 2018 and Jul 2019, across 7 billing codes. Its largest line is D0120, dental checkup, returning patient — 36% of everything it billed.
33Billing provider infoBOLEN FAMILY DENTISTRY P.C.
SIOUX FALLS, SD 57105
SIOUX FALLS, SD 57105
33aNPI1073819991assigned 02/10/2011
33bProvider typeDental Clinic/Center
28Total paid$31K
24GClaims985
24DCodes billed7
24AFirst – last monthJan 2018 – Jul 2019
Compared with peers
Next to other Dental Clinic/Center providers in South Dakota
Rank by total paid#27 of 54
Median peer was paid$30K
This provider vs. median1.0×
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 | 825 | $27K | |
| 2019 | 160 | $4K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 36% | 415 | 415 | $11K |
| D1110 | Prophylaxis - adult | 32% | 208 | 208 | $10K |
| D1206 | Topical application of fluoride varnish | 14% | 204 | 204 | $4K |
| D1120 | Dental cleaning, childProphylaxis - child | 12% | 105 | 105 | $4K |
| D0274 | Bitewings - four radiographic images | 2.8% | 25 | 25 | $868.59 |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 1.9% | 16 | 13 | $591.20 |
| D0272 | Bitewings - two radiographic images | 1.0% | 12 | 12 | $321.00 |
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 officialBOLEN, KARI (DIRECTOR/PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| Bolen Dental PC | Custer, SD | $478.27 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.