Pedavoli, Thomas

Pedavoli, Thomas was paid $38K by Medicaid between Feb 2018 and Jan 2024, across 3 billing codes. Its largest line is D1110, Prophylaxis - adult — 58% of everything it billed.

33Billing provider infoPEDAVOLI, THOMAS
SOUTH BEND, IN 46617

33aNPI1134148349assigned 07/19/2006

33bProvider typeGeneral Practice Dentistry

28Total paid$38K

24GClaims1,340

24DCodes billed3

24AFirst – last monthFeb 2018 – Jan 2024

Compared with peers

Next to other General Practice Dentistry providers in Indiana

Rank by total paid#415 of 723

Median peer was paid$60K

This provider vs. median0.6×

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	182	$2K
2019	199	$6K
2020	176	$5K
2021	181	$6K
2022	250	$7K
2023	316	$10K
2024incomplete	36	$2K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1110	Prophylaxis - adult	58%	542	527	$22K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	41%	786	752	$15K
D1206	Topical application of fluoride varnish	<1%	12	12	$267.00

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.