Dental
Surf's Up Pediatric Dentistry
Surf's Up Pediatric Dentistry was paid $154K by Medicaid between Apr 2024 and Dec 2024, across 16 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 45% of everything it billed.
33Billing provider infoSURF'S UP PEDIATRIC DENTISTRY
PAPILLION, NE 68133
PAPILLION, NE 68133
33aNPI1104571249assigned 02/17/2022
33bProvider typePediatric Dentist
28Total paid$154K
24GClaims3,982
24DCodes billed16
24AFirst – last monthApr 2024 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Nebraska
Rank by total paid#32 of 52
Median peer was paid$292K
This provider vs. median0.5×
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 | |
|---|---|---|---|
| 2024incomplete | 3,982 | $154K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 45% | 445 | 95 | $69K |
| D1120 | Dental cleaning, childProphylaxis - child | 14% | 638 | 631 | $21K |
| D1206 | Topical application of fluoride varnish | 10% | 591 | 586 | $15K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 7.7% | 432 | 425 | $12K |
| D1351 | Sealant - per tooth | 5.2% | 240 | 45 | $8K |
| D0272 | Bitewings - two radiographic images | 3.0% | 273 | 268 | $5K |
| D7140 | Extraction, erupted tooth or exposed root | 2.8% | 49 | 26 | $4K |
| D0145 | Oral evaluation for a patient under three years of age | 2.6% | 82 | 81 | $4K |
| D0140 | Limited oral evaluation - problem focused | 2.1% | 115 | 113 | $3K |
| D0240 | 1.8% | 459 | 165 | $3K | |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.5% | 80 | 79 | $2K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 1.4% | 57 | 56 | $2K |
4 more codes
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 officialCUSHING, BRYCE (OWNER/CEO)