Dental
RSVF Polk PLLC
RSVF Polk PLLC was paid $4.20M by Medicaid between Feb 2018 and Dec 2024, across 28 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 25% of everything it billed.
33Billing provider infoRSVF POLK PLLC
DALLAS, TX 75224
DALLAS, TX 75224
33aNPI1255707345assigned 08/12/2015
33bProvider typeGeneral Practice Dentistry
28Total paid$4.20M
24GClaims125,183
24DCodes billed28
24AFirst – last monthFeb 2018 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in Texas
Rank by total paid#76 of 2,774
Median peer was paid$43K
This provider vs. median98×
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 | 37 | $617.40 | |
| 2020 | 2,159 | $64K | |
| 2021 | 24,941 | $786K | |
| 2022 | 33,583 | $1.22M | |
| 2023 | 36,072 | $1.24M | |
| 2024incomplete | 28,391 | $884K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 25% | 10,615 | 4,444 | $1.03M |
| D0145 | Oral evaluation for a patient under three years of age | 9.9% | 2,975 | 2,962 | $416K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 7.5% | 2,175 | 390 | $314K |
| D1120 | Dental cleaning, childProphylaxis - child | 7.3% | 8,628 | 8,559 | $308K |
| D1351 | Sealant - per tooth | 6.4% | 10,142 | 3,157 | $269K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 6.0% | 8,913 | 8,836 | $252K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 5.8% | 3,244 | 1,850 | $245K |
| D0230 | Intraoral - periapical each additional radiographic image | 4.8% | 19,127 | 9,315 | $200K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 4.2% | 6,830 | 6,701 | $176K |
| D1208 | Topical application of fluoride, excluding varnish | 3.8% | 11,264 | 11,171 | $162K |
| D0210 | Intraoral - complete series of radiographic images | 3.2% | 2,093 | 2,067 | $136K |
| D0220 | Intraoral - periapical first radiographic image | 2.9% | 10,173 | 10,056 | $120K |
16 more codes
| D7240 | Removal of impacted tooth - completely bony | 2.3% | 337 | $95K |
| D1110 | Prophylaxis - adult | 2.1% | 1,678 | $86K |
| D0274 | Bitewings - four radiographic images | 1.7% | 2,124 | $72K |
| D0272 | Bitewings - two radiographic images | 1.7% | 3,151 | $72K |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.5% | 1,836 | $63K |
| D9248 | 1.5% | 546 | $62K | |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 1.4% | 733 | $59K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 324 | $32K |
| D0160 | <1% | 837 | $12K | |
| D1330 | <1% | 819 | $8K | |
| D7230 | <1% | 20 | $3K | |
| D0140 | Limited oral evaluation - problem focused | <1% | 180 | $3K |
| D0330 | Panoramic radiographic image | <1% | 40 | $2K |
| D2330 | <1% | 24 | $2K | |
| D0350 | <1% | 39 | $496.26 | |
| D0603 | 0% | 16,316 | $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 officialFATOUREHCHIAN, ARA (MANAGING MEMBER)