Clinic
86TH Street Complete Dental LLC
86TH Street Complete Dental LLC was paid $550K by Medicaid between Jun 2018 and Dec 2024, across 16 billing codes. Its largest line is D0210, Intraoral - complete series of radiographic images — 19% of everything it billed.
33Billing provider info86TH STREET COMPLETE DENTAL LLC
INDIANAPOLIS, IN 46268
INDIANAPOLIS, IN 46268
33aNPI1194247940assigned 07/13/2017
33bProvider typeDental Clinic/Center
28Total paid$550K
24GClaims12,112
24DCodes billed16
24AFirst – last monthJun 2018 – Dec 2024
Compared with peers
Next to other Dental Clinic/Center providers in Indiana
Rank by total paid#38 of 123
Median peer was paid$191K
This provider vs. median2.9×
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 | 145 | $178.75 | |
| 2019 | 411 | $16K | |
| 2020 | 1,243 | $52K | |
| 2021 | 2,028 | $91K | |
| 2022 | 2,884 | $134K | |
| 2023 | 3,021 | $143K | |
| 2024incomplete | 2,380 | $113K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0210 | Intraoral - complete series of radiographic images | 19% | 2,017 | 1,921 | $106K |
| D1110 | Prophylaxis - adult | 19% | 1,950 | 1,859 | $103K |
| D0150 | Comprehensive oral evaluation - new or established patient | 17% | 2,440 | 2,301 | $96K |
| D0274 | Bitewings - four radiographic images | 12% | 1,997 | 1,878 | $67K |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 10.0% | 324 | 129 | $55K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 5.9% | 1,345 | 1,274 | $32K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 4.9% | 316 | 159 | $27K |
| D0330 | Panoramic radiographic image | 3.7% | 623 | 555 | $20K |
| D7240 | Removal of impacted tooth - completely bony | 2.1% | 34 | 12 | $11K |
| D0140 | Limited oral evaluation - problem focused | 1.7% | 252 | 226 | $10K |
| D1208 | Topical application of fluoride, excluding varnish | 1.6% | 454 | 427 | $9K |
| D1206 | Topical application of fluoride varnish | <1% | 195 | 185 | $4K |
4 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 officialSINGH, MONA (OWNER)