Dental
Ikdo South Meridian LLC
Ikdo South Meridian LLC was paid $69K by Medicaid between Apr 2021 and Sep 2022, across 14 billing codes. Its largest line is D1120, dental cleaning, child — 42% of everything it billed.
33Billing provider infoIKDO SOUTH MERIDIAN LLC
MERIDIAN, ID 83642
MERIDIAN, ID 83642
33aNPI1174145684assigned 05/07/2020
33bProvider typeOrthodontics and Dentofacial Orthopedic Dentist
28Total paid$69K
24GClaims3,415
24DCodes billed14
24AFirst – last monthApr 2021 – Sep 2022
Compared with peers
Next to other Orthodontics and Dentofacial Orthopedic Dentist providers in Idaho
Rank by total paid#11 of 29
Median peer was paid$43K
This provider vs. median1.6×
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 | |
|---|---|---|---|
| 2021 | 830 | $15K | |
| 2022 | 2,585 | $53K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 42% | 656 | 656 | $29K |
| D0330 | Panoramic radiographic image | 21% | 143 | 143 | $14K |
| D0150 | Comprehensive oral evaluation - new or established patient | 11% | 303 | 303 | $8K |
| D1110 | Prophylaxis - adult | 9.6% | 92 | 92 | $7K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 8.7% | 71 | 46 | $6K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 5.2% | 34 | 13 | $4K |
| D1351 | Sealant - per tooth | 1.0% | 245 | 51 | $708.22 |
| D0272 | Bitewings - two radiographic images | <1% | 493 | 493 | $138.69 |
| D0274 | Bitewings - four radiographic images | <1% | 80 | 80 | $131.40 |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | <1% | 338 | 338 | $128.86 |
| D1206 | Topical application of fluoride varnish | <1% | 380 | 380 | $77.83 |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | <1% | 204 | 184 | $15.87 |
2 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 officialPAYNE, MICHAEL (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Ikdo Fruitland LLC | Fruitland, ID | $214K |
| Ikdo Star LLC | Star, ID | $66K |
| MT Washington Family Practice PLLC | Mt Washington, KY | $20K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.