Clinic
Restoration Dental Group LLC
Restoration Dental Group LLC was paid $3K by Medicaid between Aug 2022 and Jun 2023, across 4 billing codes. Its largest line is D0120, dental checkup, returning patient — 60% of everything it billed.
33Billing provider infoRESTORATION DENTAL GROUP LLC
SHREVEPORT, LA 71105
SHREVEPORT, LA 71105
33aNPI1093035081assigned 06/02/2010
33bProvider typeDental Clinic/Center
28Total paid$3K
24GClaims105
24DCodes billed4
24AFirst – last monthAug 2022 – Jun 2023
Compared with peers
Next to other Dental Clinic/Center providers in Louisiana
Rank by total paid#54 of 59
Median peer was paid$90K
This provider vs. median0.0×
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 | |
|---|---|---|---|
| 2022 | 42 | $1K | |
| 2023 | 63 | $2K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 60% | 68 | 68 | $2K |
| D1110 | Prophylaxis - adult | 19% | 12 | 12 | $576.12 |
| D1120 | Dental cleaning, childProphylaxis - child | 13% | 12 | 12 | $385.22 |
| D1208 | Topical application of fluoride, excluding varnish | 8.4% | 13 | 13 | $257.01 |
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 officialJARVIS, RAYMOND (OWNER OF RESTORATION DENTAL GROUP L)