Dental
Lebanon Pediatric Dentistry, LLC
Lebanon Pediatric Dentistry, LLC was paid $3.96M by Medicaid between Sep 2020 and Dec 2024, across 31 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 22% of everything it billed.
33Billing provider infoLEBANON PEDIATRIC DENTISTRY, LLC
LEBANON, TN 37090
LEBANON, TN 37090
33aNPI1285279836assigned 11/07/2019
33bProvider typePediatric Dentist
28Total paid$3.96M
24GClaims90,122
24DCodes billed31
24AFirst – last monthSep 2020 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Tennessee
Rank by total paid#23 of 112
Median peer was paid$1.03M
This provider vs. median3.8×
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 | |
|---|---|---|---|
| 2020 | 2,518 | $82K | |
| 2021 | 13,900 | $504K | |
| 2022 | 17,392 | $655K | |
| 2023 | 26,448 | $1.27M | |
| 2024incomplete | 29,864 | $1.45M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 22% | 8,184 | 1,784 | $874K |
| D1120 | Dental cleaning, childProphylaxis - child | 10% | 12,491 | 11,930 | $402K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 9.1% | 4,549 | 966 | $361K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 7.2% | 12,167 | 11,620 | $285K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 6.4% | 3,581 | 1,797 | $253K |
| D2933 | 5.8% | 1,597 | 358 | $231K | |
| D1208 | Topical application of fluoride, excluding varnish | 5.8% | 11,291 | 10,768 | $229K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 4.3% | 2,875 | 1,602 | $172K |
| D9248 | 3.0% | 1,605 | 1,485 | $118K | |
| D7140 | Extraction, erupted tooth or exposed root | 2.6% | 1,710 | 811 | $102K |
| D0330 | Panoramic radiographic image | 2.6% | 2,756 | 2,612 | $102K |
| D1110 | Prophylaxis - adult | 2.5% | 2,415 | 2,297 | $99K |
19 more codes
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 2.4% | 3,807 | $97K |
| D0272 | Bitewings - two radiographic images | 2.4% | 6,038 | $96K |
| D7240 | Removal of impacted tooth - completely bony | 2.4% | 383 | $93K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.3% | 3,218 | $89K |
| D1351 | Sealant - per tooth | 1.8% | 2,403 | $72K |
| D1206 | Topical application of fluoride varnish | 1.6% | 3,227 | $64K |
| D9223 | Deep sedation/general anesthesia - each subsequent 15 minute increment | 1.3% | 681 | $53K |
| D9222 | <1% | 473 | $39K | |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 350 | $29K |
| D2332 | <1% | 209 | $17K | |
| D0140 | Limited oral evaluation - problem focused | <1% | 746 | $16K |
| D7230 | <1% | 73 | $16K | |
| D0220 | Intraoral - periapical first radiographic image | <1% | 1,340 | $15K |
| D9610 | <1% | 483 | $11K | |
| D0274 | Bitewings - four radiographic images | <1% | 380 | $9K |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | <1% | 53 | $7K |
| D1510 | <1% | 50 | $6K | |
| D9420 | <1% | 970 | $240.00 | |
| D1999 | 0% | 17 | $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 officialSIMS, CHRISTOPHER (CREDENTIALING COORDINATOR)
| Provider | Location | Paid |
|---|---|---|
| Waynesburg Clinic, PLLC | Waynesburg, KY | $400K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.