Dental
Pediatric Dentistry of Salem LLC
Pediatric Dentistry of Salem LLC was paid $711K by Medicaid between Jan 2018 and Jan 2022, across 20 billing codes. Its largest line is D1120, dental cleaning, child — 22% of everything it billed.
33Billing provider infoPEDIATRIC DENTISTRY OF SALEM LLC
SALEM, OR 97302
SALEM, OR 97302
33aNPI1184831083assigned 05/17/2007
33bProvider typePediatric Dentist
28Total paid$711K
24GClaims12,303
24DCodes billed20
24AFirst – last monthJan 2018 – Jan 2022
Compared with peers
Next to other Pediatric Dentist providers in Oregon
Rank by total paid#31 of 109
Median peer was paid$362K
This provider vs. median2.0×
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 | 3,489 | $212K | |
| 2019 | 3,221 | $196K | |
| 2020 | 2,570 | $122K | |
| 2021 | 2,982 | $178K | |
| 2022 | 41 | $2K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 22% | 2,471 | 2,427 | $155K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 19% | 2,500 | 2,478 | $134K |
| D1208 | Topical application of fluoride, excluding varnish | 16% | 3,231 | 3,178 | $116K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 8.9% | 306 | 90 | $63K |
| D1110 | Prophylaxis - adult | 7.7% | 689 | 682 | $54K |
| D0272 | Bitewings - two radiographic images | 6.9% | 1,255 | 1,228 | $49K |
| D2150 | Silver amalgam - two surfaces, primary or permanent | 5.2% | 283 | 131 | $37K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 3.0% | 93 | 52 | $21K |
| D0140 | Limited oral evaluation - problem focused | 2.7% | 269 | 262 | $19K |
| D0220 | Intraoral - periapical first radiographic image | 1.4% | 394 | 373 | $10K |
| D9420 | 1.4% | 41 | 38 | $10K | |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 1.2% | 54 | 25 | $9K |
8 more codes
| D0150 | Comprehensive oral evaluation - new or established patient | 1.1% | 93 | $8K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 44 | $7K |
| D2140 | <1% | 59 | $7K | |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 243 | $5K |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 24 | $3K |
| D1999 | <1% | 228 | $1K | |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | <1% | 14 | $1K |
| D0274 | Bitewings - four radiographic images | <1% | 12 | $799.20 |
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 officialHERINGER, WESTON (PARTNER)