Dental
Advanced Dental Care of Summerlin Place
Advanced Dental Care of Summerlin Place was paid $5K by Medicaid between May 2023 and Aug 2023, across 3 billing codes. Its largest line is D0210, Intraoral - complete series of radiographic images — 43% of everything it billed.
33Billing provider infoADVANCED DENTAL CARE OF SUMMERLIN PLACE
INDIANAPOLIS, IN 46208
INDIANAPOLIS, IN 46208
33aNPI1093322026assigned 09/24/2020
33bProvider typeGeneral Practice Dentistry
28Total paid$5K
24GClaims105
24DCodes billed3
24AFirst – last monthMay 2023 – Aug 2023
Compared with peers
Next to other General Practice Dentistry providers in Indiana
Rank by total paid#556 of 723
Median peer was paid$60K
This provider vs. median0.1×
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 | |
|---|---|---|---|
| 2023 | 105 | $5K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0210 | Intraoral - complete series of radiographic images | 43% | 35 | 26 | $2K |
| D0150 | Comprehensive oral evaluation - new or established patient | 42% | 54 | 43 | $2K |
| D1110 | Prophylaxis - adult | 15% | 16 | 14 | $749.72 |
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 officialSUMMERLIN, JACK (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Advanced Dental Care of Fortville, LLC | Fortville, IN | $43K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.