Dental
Kentuckiana Peds Dre LLC
Kentuckiana Peds Dre LLC was paid $373K by Medicaid between Mar 2024 and Dec 2024, across 21 billing codes. Its largest line is D1120, dental cleaning, child — 26% of everything it billed.
33Billing provider infoKENTUCKIANA PEDS DRE LLC
MT WASHINGTON, KY 40047
MT WASHINGTON, KY 40047
33aNPI1093580219assigned 11/17/2023
33bProvider typePediatric Dentist
28Total paid$373K
24GClaims10,663
24DCodes billed21
24AFirst – last monthMar 2024 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Kentucky
Rank by total paid#75 of 134
Median peer was paid$467K
This provider vs. median0.8×
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official DAVIS, ELIZABETH controls 20+ related entities in our dataset. Read more
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 | |
|---|---|---|---|
| 2024incomplete | 10,663 | $373K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 26% | 1,842 | 1,653 | $98K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 13% | 2,012 | 1,818 | $49K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 8.8% | 400 | 148 | $33K |
| D1208 | Topical application of fluoride, excluding varnish | 8.5% | 1,943 | 1,744 | $32K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 7.8% | 507 | 248 | $29K |
| D1110 | Prophylaxis - adult | 6.5% | 448 | 406 | $24K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 6.1% | 470 | 263 | $23K |
| D0272 | Bitewings - two radiographic images | 4.7% | 957 | 849 | $17K |
| D7140 | Extraction, erupted tooth or exposed root | 4.2% | 384 | 142 | $16K |
| D0330 | Panoramic radiographic image | 3.9% | 368 | 317 | $15K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 2.4% | 243 | 214 | $9K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.0% | 263 | 234 | $8K |
9 more codes
| D0274 | Bitewings - four radiographic images | 1.8% | 238 | $7K |
| D0140 | Limited oral evaluation - problem focused | 1.1% | 115 | $4K |
| D9420 | <1% | 65 | $3K | |
| D0220 | Intraoral - periapical first radiographic image | <1% | 219 | $2K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | <1% | 49 | $2K |
| D2331 | <1% | 31 | $1K | |
| D2330 | <1% | 17 | $977.46 | |
| D1351 | Sealant - per tooth | <1% | 65 | $717.98 |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 27 | $127.91 |
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 officialDAVIS, ELIZABETH (DIRECTOR OF REVENUE)
| Provider | Location | Paid |
|---|---|---|
| Geriatric Services, INC. | Teaneck, NJ | $5.89M |
| Geriatric Living Solutions, INC. | Teaneck, NJ | $4.34M |
| Central Kentucky Sedation PLLC | Lexington, KY | $1.37M |
| Etown Dentistry Dre LLC | Elizabethtown, KY | $690K |
| Wise Dentistry Dre LLC | Campbellsville, KY | $411K |
| Danville Peds Dre LLC | Danville, KY | $361K |
| Gelsomino and Davis Speech and Occupational Therapy | Liberty, NY | $343K |
| Pdos Dre LLC | Shelbyville, KY | $323K |
| Barnhill Peds Dre LLC | Corbin, KY | $265K |
| Beaumont Kids Dre LLC | Lexington, KY | $175K |
| Pdow Dre LLC | Winchester, KY | $145K |
| Crisp Dre LLC | Winchester, KY | $142K |
| Liz Davis LPC LLC | Stamford, CT | $119K |
| Thrive Wellness, LLC | Durango, CO | $118K |
| Main Street Family Medical, LLC | Spiro, OK | $115K |
| Bluegrass Peds Dre LLC | Richmond, KY | $114K |
| DFC Dre LLC | Lexington, KY | $84K |
| KBD Kids Dre LLC | London, KY | $72K |
| Morehead Peds Dre LLC | Morehead, KY | $61K |
| MT Sterling Peds Dre LLC | Mt Sterling, KY | $57K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.