Dental
Clevidence, Dustin
Clevidence, Dustin was paid $476K by Medicaid between Jan 2018 and Jan 2024, across 19 billing codes. Its largest line is D1120, dental cleaning, child — 16% of everything it billed.
33Billing provider infoCLEVIDENCE, DUSTIN
EVANSVILLE, IN 47715
EVANSVILLE, IN 47715
33aNPI1114364692assigned 05/24/2013
33bProvider typeGeneral Practice Dentistry
28Total paid$476K
24GClaims27,943
24DCodes billed19
24AFirst – last monthJan 2018 – Jan 2024
Compared with peers
Next to other General Practice Dentistry providers in Indiana
Rank by total paid#132 of 723
Median peer was paid$60K
This provider vs. median8.0×
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 | |
|---|---|---|---|
| 2018 | 12,449 | $90K | |
| 2019 | 7,845 | $209K | |
| 2020 | 6,049 | $140K | |
| 2021 | 1,168 | $32K | |
| 2023 | 417 | $4K | |
| 2024incomplete | 15 | $441.00 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 16% | 3,421 | 2,608 | $75K |
| D1351 | Sealant - per tooth | 13% | 3,916 | 694 | $61K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 11% | 3,361 | 2,509 | $51K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 8.6% | 701 | 258 | $41K |
| D1206 | Topical application of fluoride varnish | 7.6% | 2,427 | 1,719 | $36K |
| D1110 | Prophylaxis - adult | 6.9% | 1,061 | 776 | $33K |
| D0272 | Bitewings - two radiographic images | 6.0% | 2,047 | 1,486 | $28K |
| D0150 | Comprehensive oral evaluation - new or established patient | 5.8% | 1,291 | 1,023 | $27K |
| D1208 | Topical application of fluoride, excluding varnish | 5.5% | 1,895 | 1,550 | $26K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 5.4% | 1,471 | 966 | $26K |
| D0210 | Intraoral - complete series of radiographic images | 5.0% | 670 | 524 | $24K |
| D2140 | 2.8% | 612 | 296 | $13K |
7 more codes
| D0274 | Bitewings - four radiographic images | 2.7% | 660 | $13K |
| D0220 | Intraoral - periapical first radiographic image | 2.5% | 1,744 | $12K |
| D0230 | Intraoral - periapical each additional radiographic image | 1.4% | 1,472 | $7K |
| D0330 | Panoramic radiographic image | <1% | 443 | $1K |
| D0140 | Limited oral evaluation - problem focused | <1% | 16 | $593.28 |
| D1999 | 0% | 722 | $0.00 | |
| D2150 | Silver amalgam - two surfaces, primary or permanent | 0% | 13 | $0.00 |
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.