Dental
Clermont Kids Dentistry PA
Clermont Kids Dentistry PA was paid $136K by Medicaid between Apr 2019 and Dec 2021, across 28 billing codes. Its largest line is D9230, Inhalation of nitrous oxide / analgesia, anxiolysis — 24% of everything it billed.
33Billing provider infoCLERMONT KIDS DENTISTRY PA
CLERMONT, FL 34711
CLERMONT, FL 34711
33aNPI1164998308assigned 10/15/2018
33bProvider typePediatric Dentist
28Total paid$136K
24GClaims6,877
24DCodes billed28
24AFirst – last monthApr 2019 – Dec 2021
Compared with peers
Next to other Pediatric Dentist providers in Florida
Rank by total paid#114 of 246
Median peer was paid$107K
This provider vs. median1.3×
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 | |
|---|---|---|---|
| 2019 | 1,433 | $31K | |
| 2020 | 4,036 | $86K | |
| 2021 | 1,408 | $19K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 24% | 234 | 202 | $33K |
| D0150 | Comprehensive oral evaluation - new or established patient | 19% | 480 | 465 | $25K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 16% | 430 | 425 | $21K |
| D1120 | Dental cleaning, childProphylaxis - child | 11% | 880 | 866 | $15K |
| D1330 | 9.4% | 924 | 905 | $13K | |
| D2930 | Prefabricated stainless steel crown - primary tooth | 6.2% | 178 | 95 | $8K |
| D0272 | Bitewings - two radiographic images | 3.2% | 474 | 468 | $4K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 1.9% | 79 | 51 | $3K |
| D0140 | Limited oral evaluation - problem focused | 1.9% | 106 | 100 | $3K |
| D1999 | 1.7% | 43 | 42 | $2K | |
| D1351 | Sealant - per tooth | 1.3% | 187 | 49 | $2K |
| D0240 | 1.1% | 121 | 120 | $1K |
16 more codes
| D0145 | Oral evaluation for a patient under three years of age | 1.1% | 27 | $1K |
| D9920 | <1% | 74 | $666.05 | |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 75 | $622.55 |
| D0220 | Intraoral - periapical first radiographic image | <1% | 351 | $619.55 |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 22 | $590.10 |
| D0330 | Panoramic radiographic image | <1% | 154 | $441.10 |
| D0999 | Unspecified diagnostic procedure, by report | <1% | 17 | $340.00 |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 485 | $318.40 |
| D9995 | <1% | 12 | $272.25 | |
| D0602 | <1% | 499 | $162.50 | |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 457 | $133.20 |
| D1206 | Topical application of fluoride varnish | <1% | 384 | $16.00 |
| D1110 | Prophylaxis - adult | 0% | 12 | $0.00 |
| D0603 | 0% | 83 | $0.00 | |
| D0601 | 0% | 70 | $0.00 | |
| D9999 | Unspecified adjunctive procedure, by report | 0% | 19 | $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.
From NPPES
Who's on the registration
Authorized officialTARTIBI, FARAZ (OWNER)