Clinic
Advanced Dental Care of Fortville, LLC
Advanced Dental Care of Fortville, LLC was paid $43K by Medicaid between Jan 2021 and Jan 2024, across 7 billing codes. Its largest line is D1110, Prophylaxis - adult — 35% of everything it billed.
33Billing provider infoADVANCED DENTAL CARE OF FORTVILLE, LLC
FORTVILLE, IN 46040
FORTVILLE, IN 46040
33aNPI1205454014assigned 07/08/2020
33bProvider typeDental Clinic/Center
28Total paid$43K
24GClaims1,102
24DCodes billed7
24AFirst – last monthJan 2021 – Jan 2024
Compared with peers
Next to other Dental Clinic/Center providers in Indiana
Rank by total paid#84 of 123
Median peer was paid$191K
This provider vs. median0.2×
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 | |
|---|---|---|---|
| 2021 | 81 | $4K | |
| 2022 | 253 | $10K | |
| 2023 | 734 | $27K | |
| 2024incomplete | 34 | $2K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 35% | 310 | 279 | $15K |
| D0150 | Comprehensive oral evaluation - new or established patient | 25% | 285 | 260 | $11K |
| D0210 | Intraoral - complete series of radiographic images | 22% | 189 | 157 | $9K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 11% | 199 | 180 | $5K |
| D1206 | Topical application of fluoride varnish | 3.3% | 72 | 66 | $1K |
| D0274 | Bitewings - four radiographic images | 2.4% | 31 | 31 | $1K |
| D0220 | Intraoral - periapical first radiographic image | <1% | 16 | 15 | $221.32 |
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 officialSUMMERLIN, JACK (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Advanced Dental Care of Summerlin Place | Indianapolis, IN | $5K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.