Dental
Pediatric Dentistry of Southern Kentucky
Pediatric Dentistry of Southern Kentucky was paid $9.02M by Medicaid between Mar 2018 and Dec 2024, across 29 billing codes. Its largest line is D1120, dental cleaning, child — 26% of everything it billed.
33Billing provider infoPEDIATRIC DENTISTRY OF SOUTHERN KENTUCKY
BOWLING GREEN, KY 42103
BOWLING GREEN, KY 42103
33aNPI1083067482assigned 07/20/2016
33bProvider typePediatric Dentist
28Total paid$9.02M
24GClaims252,552
24DCodes billed29
24AFirst – last monthMar 2018 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Kentucky
Rank by total paid#2 of 134
Median peer was paid$467K
This provider vs. median19×
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 | 1,254 | $34K | |
| 2019 | 1,905 | $52K | |
| 2020 | 8,694 | $207K | |
| 2021 | 30,215 | $955K | |
| 2022 | 54,042 | $1.82M | |
| 2023 | 84,987 | $3.19M | |
| 2024incomplete | 71,455 | $2.76M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 26% | 41,626 | 41,026 | $2.35M |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 11% | 40,490 | 39,895 | $1.01M |
| D7140 | Extraction, erupted tooth or exposed root | 8.8% | 12,223 | 5,371 | $795K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 7.4% | 6,041 | 1,609 | $663K |
| D0330 | Panoramic radiographic image | 6.4% | 9,917 | 9,738 | $580K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 5.3% | 9,007 | 5,546 | $477K |
| D0272 | Bitewings - two radiographic images | 4.8% | 21,633 | 21,299 | $437K |
| D1208 | Topical application of fluoride, excluding varnish | 4.8% | 26,403 | 26,116 | $429K |
| D1351 | Sealant - per tooth | 4.2% | 20,158 | 6,064 | $381K |
| D1206 | Topical application of fluoride varnish | 3.6% | 18,333 | 17,929 | $327K |
| D1110 | Prophylaxis - adult | 3.0% | 4,821 | 4,709 | $267K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 2.6% | 6,792 | 6,626 | $231K |
17 more codes
| D2934 | 2.5% | 2,200 | $230K | |
| D9248 | 2.5% | 3,640 | $229K | |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.3% | 7,075 | $206K |
| D0140 | Limited oral evaluation - problem focused | <1% | 2,305 | $79K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | <1% | 1,115 | $74K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | <1% | 953 | $56K |
| D9420 | <1% | 727 | $43K | |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 4,159 | $33K |
| D2330 | <1% | 556 | $29K | |
| D0220 | Intraoral - periapical first radiographic image | <1% | 2,378 | $26K |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 773 | $22K |
| D0210 | Intraoral - complete series of radiographic images | <1% | 392 | $18K |
| D7111 | <1% | 229 | $13K | |
| D3110 | <1% | 516 | $8K | |
| D9986 | <1% | 5,470 | $6K | |
| D1354 | <1% | 39 | $309.50 | |
| D1999 | 0% | 2,581 | $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 officialPATTEE, SHANNON (BILLING MANAGER)