Dental
Ikdo Fruitland LLC
Ikdo Fruitland LLC was paid $214K by Medicaid between Oct 2018 and Aug 2022, across 19 billing codes. Its largest line is D1120, dental cleaning, child — 37% of everything it billed.
33Billing provider infoIKDO FRUITLAND LLC
FRUITLAND, ID 83619
FRUITLAND, ID 83619
33aNPI1184108706assigned 09/19/2018
33bProvider typeOrthodontics and Dentofacial Orthopedic Dentist
28Total paid$214K
24GClaims10,907
24DCodes billed19
24AFirst – last monthOct 2018 – Aug 2022
Compared with peers
Next to other Orthodontics and Dentofacial Orthopedic Dentist providers in Idaho
Rank by total paid#4 of 29
Median peer was paid$43K
This provider vs. median5.0×
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 | 115 | $2K | |
| 2019 | 1,258 | $22K | |
| 2020 | 2,663 | $53K | |
| 2021 | 4,267 | $85K | |
| 2022 | 2,604 | $53K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 37% | 1,647 | 1,639 | $78K |
| D1110 | Prophylaxis - adult | 15% | 450 | 450 | $32K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 13% | 363 | 230 | $27K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 9.2% | 432 | 266 | $20K |
| D0330 | Panoramic radiographic image | 7.4% | 251 | 248 | $16K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 4.5% | 1,510 | 1,504 | $10K |
| D1351 | Sealant - per tooth | 3.6% | 1,370 | 319 | $8K |
| D0150 | Comprehensive oral evaluation - new or established patient | 3.2% | 517 | 514 | $7K |
| D0272 | Bitewings - two radiographic images | 2.2% | 1,188 | 1,177 | $5K |
| D1206 | Topical application of fluoride varnish | 1.8% | 1,700 | 1,697 | $4K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 1.2% | 642 | 589 | $3K |
| D0274 | Bitewings - four radiographic images | 1.1% | 330 | 330 | $2K |
7 more codes
| D8670 | Periodic orthodontic treatment visit | <1% | 26 | $1K |
| D0210 | Intraoral - complete series of radiographic images | <1% | 14 | $887.87 |
| D0140 | Limited oral evaluation - problem focused | <1% | 24 | $873.24 |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 332 | $323.00 |
| D0220 | Intraoral - periapical first radiographic image | <1% | 82 | $117.00 |
| D0240 | <1% | 16 | $48.00 | |
| D0145 | Oral evaluation for a patient under three years of age | 0% | 13 | $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 officialPAYNE, MICHAEL (PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| Ikdo South Meridian LLC | Meridian, ID | $69K |
| 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.