Clinic
Renfroe Family Dental
Renfroe Family Dental was paid $36K by Medicaid between Aug 2021 and Nov 2022, across 7 billing codes. Its largest line is D1110, Prophylaxis - adult — 26% of everything it billed.
33Billing provider infoRENFROE FAMILY DENTAL
DOVER, TN 37058
DOVER, TN 37058
33aNPI1104310895assigned 06/18/2018
33bProvider typeDental Clinic/Center
28Total paid$36K
24GClaims1,423
24DCodes billed7
24AFirst – last monthAug 2021 – Nov 2022
Compared with peers
Next to other Dental Clinic/Center providers in Tennessee
Rank by total paid#36 of 40
Median peer was paid$259K
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 | |
|---|---|---|---|
| 2021 | 509 | $13K | |
| 2022 | 914 | $23K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 26% | 247 | 245 | $9K |
| D1206 | Topical application of fluoride varnish | 25% | 481 | 473 | $9K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 24% | 393 | 386 | $9K |
| D1120 | Dental cleaning, childProphylaxis - child | 22% | 262 | 255 | $8K |
| D0330 | Panoramic radiographic image | 1.4% | 12 | 12 | $497.30 |
| D0274 | Bitewings - four radiographic images | 1.1% | 14 | 14 | $399.84 |
| D0272 | Bitewings - two radiographic images | <1% | 14 | 12 | $203.83 |
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, JORDAN (OFFICE MANAGER)