Dental
Summit Dental Health - Blondo LLC
Summit Dental Health - Blondo LLC was paid $2.19M by Medicaid between Jan 2018 and Dec 2024, across 22 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 17% of everything it billed.
33Billing provider infoSUMMIT DENTAL HEALTH - BLONDO LLC
OMAHA, NE 68134
OMAHA, NE 68134
33aNPI1124418892assigned 02/02/2015
33bProvider typeGeneral Practice Dentistry
28Total paid$2.19M
24GClaims57,844
24DCodes billed22
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in Nebraska
Rank by total paid#3 of 201
Median peer was paid$21K
This provider vs. median103×
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 | 4,243 | $85K | |
| 2019 | 4,200 | $77K | |
| 2020 | 3,077 | $66K | |
| 2021 | 5,935 | $136K | |
| 2022 | 9,450 | $450K | |
| 2023 | 15,062 | $712K | |
| 2024incomplete | 15,877 | $664K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 17% | 2,622 | 1,510 | $361K |
| D0210 | Intraoral - complete series of radiographic images | 11% | 2,982 | 2,980 | $247K |
| D1206 | Topical application of fluoride varnish | 11% | 6,417 | 6,279 | $235K |
| D1110 | Prophylaxis - adult | 10% | 3,709 | 3,678 | $222K |
| D0150 | Comprehensive oral evaluation - new or established patient | 7.8% | 4,350 | 4,292 | $170K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 7.2% | 4,266 | 4,237 | $157K |
| D1351 | Sealant - per tooth | 6.0% | 2,531 | 517 | $132K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 5.4% | 656 | 421 | $118K |
| D2740 | Crown - porcelain/ceramic | 3.8% | 130 | 117 | $84K |
| D0274 | Bitewings - four radiographic images | 3.8% | 5,243 | 5,181 | $83K |
| D1120 | Dental cleaning, childProphylaxis - child | 3.8% | 1,871 | 1,870 | $82K |
| D0330 | Panoramic radiographic image | 2.4% | 4,279 | 4,219 | $53K |
10 more codes
| D7140 | Extraction, erupted tooth or exposed root | 2.3% | 516 | $51K |
| D0230 | Intraoral - periapical each additional radiographic image | 1.9% | 8,858 | $41K |
| D0220 | Intraoral - periapical first radiographic image | 1.6% | 5,339 | $34K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 1.5% | 306 | $32K |
| D1999 | 1.2% | 2,766 | $27K | |
| D2950 | <1% | 135 | $20K | |
| D0140 | Limited oral evaluation - problem focused | <1% | 432 | $19K |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | <1% | 65 | $10K |
| D4910 | <1% | 71 | $5K | |
| D0272 | Bitewings - two radiographic images | <1% | 300 | $4K |
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 officialLOGAN, COREZ (CREDENTIALING SPECIALIST)