Dental
Family Dental of Blackfoot LLC
Family Dental of Blackfoot LLC was paid $532K by Medicaid between Jan 2018 and Dec 2024, across 23 billing codes. Its largest line is D1110, Prophylaxis - adult — 30% of everything it billed.
33Billing provider infoFAMILY DENTAL OF BLACKFOOT LLC
BLACKFOOT, ID 83221
BLACKFOOT, ID 83221
33aNPI1205208162assigned 10/30/2015
33bProvider typeDentist
28Total paid$532K
24GClaims26,997
24DCodes billed23
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Dentist providers in Idaho
Rank by total paid#12 of 89
Median peer was paid$16K
This provider vs. median34×
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 | 3,712 | $82K | |
| 2019 | 5,520 | $136K | |
| 2020 | 6,252 | $158K | |
| 2021 | 4,892 | $84K | |
| 2022 | 2,746 | $30K | |
| 2023 | 2,245 | $24K | |
| 2024incomplete | 1,630 | $17K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 30% | 1,947 | 1,944 | $158K |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 17% | 1,519 | 468 | $93K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 16% | 2,109 | 1,008 | $88K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 11% | 504 | 303 | $61K |
| D0210 | Intraoral - complete series of radiographic images | 8.3% | 532 | 530 | $44K |
| D1120 | Dental cleaning, childProphylaxis - child | 6.5% | 508 | 507 | $35K |
| D0150 | Comprehensive oral evaluation - new or established patient | 3.6% | 1,063 | 1,062 | $19K |
| D0140 | Limited oral evaluation - problem focused | 3.1% | 929 | 924 | $16K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 1.4% | 301 | 180 | $7K |
| D0330 | Panoramic radiographic image | <1% | 131 | 131 | $4K |
| D4341 | <1% | 42 | 14 | $3K | |
| D4355 | <1% | 26 | 26 | $2K |
11 more codes
| D0274 | Bitewings - four radiographic images | <1% | 1,796 | $1K |
| D4910 | <1% | 12 | $764.32 | |
| D0120 | Dental checkup, returning patient | <1% | 2,582 | $512.47 |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 595 | $467.53 |
| D2331 | <1% | 15 | $299.98 | |
| D0220 | Intraoral - periapical first radiographic image | <1% | 3,946 | $185.90 |
| D1206 | Topical application of fluoride varnish | <1% | 1,837 | $41.94 |
| D0272 | Bitewings - two radiographic images | 0% | 299 | $0.00 |
| D1999 | 0% | 14 | $0.00 | |
| D0230 | Intraoral - periapical each additional radiographic image | 0% | 5,256 | $-247.78 |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 0% | 1,034 | $-883.05 |
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 officialBURTENSHAW, BRYCE (OWNER)