Clinic
Hermitage Pediatric Dentistry
Hermitage Pediatric Dentistry was paid $19.09M by Medicaid between Jan 2018 and Dec 2024, across 33 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 15% of everything it billed.
33Billing provider infoHERMITAGE PEDIATRIC DENTISTRY
HERMITAGE, TN 37076
HERMITAGE, TN 37076
33aNPI1174852958assigned 12/08/2009
33bProvider typeDental Clinic/Center
28Total paid$19.09M
24GClaims545,800
24DCodes billed33
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Dental Clinic/Center providers in Tennessee
Rank by total paid#1 of 40
Median peer was paid$259K
This provider vs. median74×
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 | 61,270 | $2.34M | |
| 2019 | 72,329 | $2.83M | |
| 2020 | 59,385 | $2.15M | |
| 2021 | 75,008 | $2.72M | |
| 2022 | 84,347 | $2.80M | |
| 2023 | 96,467 | $3.18M | |
| 2024incomplete | 96,994 | $3.08M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 15% | 26,165 | 8,137 | $2.83M |
| D1120 | Dental cleaning, childProphylaxis - child | 14% | 79,531 | 76,861 | $2.59M |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 10% | 82,933 | 80,166 | $1.95M |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 7.7% | 20,559 | 11,290 | $1.47M |
| D1208 | Topical application of fluoride, excluding varnish | 7.5% | 71,369 | 68,849 | $1.44M |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 6.4% | 20,992 | 12,531 | $1.23M |
| D1351 | Sealant - per tooth | 4.3% | 28,002 | 9,403 | $812K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 4.2% | 29,070 | 27,216 | $795K |
| D7140 | Extraction, erupted tooth or exposed root | 4.1% | 14,027 | 7,263 | $782K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 4.1% | 9,774 | 2,885 | $777K |
| D1110 | Prophylaxis - adult | 3.8% | 17,338 | 16,686 | $718K |
| D0272 | Bitewings - two radiographic images | 3.4% | 39,037 | 37,719 | $645K |
21 more codes
| D0330 | Panoramic radiographic image | 3.4% | 16,105 | $640K |
| D9248 | 3.0% | 7,772 | $580K | |
| D1206 | Topical application of fluoride varnish | 2.4% | 22,989 | $466K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.3% | 16,075 | $444K |
| D2933 | 1.3% | 1,534 | $242K | |
| D0220 | Intraoral - periapical first radiographic image | <1% | 16,373 | $188K |
| D0140 | Limited oral evaluation - problem focused | <1% | 6,822 | $145K |
| D0274 | Bitewings - four radiographic images | <1% | 4,449 | $110K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 872 | $72K |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 6,615 | $58K |
| D1353 | <1% | 2,165 | $47K | |
| D2330 | <1% | 501 | $29K | |
| D2332 | <1% | 300 | $23K | |
| D1354 | <1% | 2,202 | $14K | |
| D2390 | <1% | 79 | $8K | |
| D1510 | <1% | 30 | $4K | |
| D2931 | <1% | 17 | $2K | |
| D2331 | <1% | 28 | $2K | |
| D1352 | <1% | 16 | $482.88 | |
| D9420 | <1% | 1,276 | $310.00 | |
| D1999 | 0% | 783 | $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 officialLARSON, KIRKLAND (DENTIST)