Dental
Autumn Ridge Dental Partnership
Autumn Ridge Dental Partnership was paid $723K by Medicaid between Jul 2018 and Dec 2024, across 16 billing codes. Its largest line is D1120, dental cleaning, child — 21% of everything it billed.
33Billing provider infoAUTUMN RIDGE DENTAL PARTNERSHIP
KOSCIUSKO, MS 39090
KOSCIUSKO, MS 39090
33aNPI1275750531assigned 04/19/2007
33bProvider typeGeneral Practice Dentistry
28Total paid$723K
24GClaims33,710
24DCodes billed16
24AFirst – last monthJul 2018 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in Mississippi
Rank by total paid#49 of 379
Median peer was paid$78K
This provider vs. median9.3×
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 | 4,588 | $11K | |
| 2019 | 5,309 | $31K | |
| 2020 | 2,581 | $58K | |
| 2021 | 5,016 | $139K | |
| 2022 | 5,699 | $169K | |
| 2023 | 5,745 | $175K | |
| 2024incomplete | 4,772 | $142K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 21% | 7,740 | 6,456 | $149K |
| D1206 | Topical application of fluoride varnish | 15% | 6,830 | 5,726 | $107K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 15% | 4,578 | 4,098 | $107K |
| D7140 | Extraction, erupted tooth or exposed root | 8.2% | 1,169 | 567 | $59K |
| D0274 | Bitewings - four radiographic images | 7.2% | 2,543 | 2,090 | $52K |
| D0140 | Limited oral evaluation - problem focused | 7.2% | 1,758 | 1,514 | $52K |
| D0210 | Intraoral - complete series of radiographic images | 6.0% | 998 | 835 | $44K |
| D0150 | Comprehensive oral evaluation - new or established patient | 4.7% | 3,057 | 2,309 | $34K |
| D1351 | Sealant - per tooth | 4.1% | 1,055 | 142 | $29K |
| D2150 | Silver amalgam - two surfaces, primary or permanent | 4.0% | 516 | 276 | $29K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 3.1% | 1,768 | 1,390 | $23K |
| D2140 | 3.0% | 467 | 273 | $22K |
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 officialWEAVER, DONALD (PARTNER)