Dental
Southern Indiana Pediatric Dentistry, LLC
Southern Indiana Pediatric Dentistry, LLC was paid $3.73M by Medicaid between Jan 2018 and Dec 2024, across 19 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 19% of everything it billed.
33Billing provider infoSOUTHERN INDIANA PEDIATRIC DENTISTRY, LLC
BLOOMINGTON, IN 47401
BLOOMINGTON, IN 47401
33aNPI1356634471assigned 05/23/2011
33bProvider typePediatric Dentist
28Total paid$3.73M
24GClaims122,833
24DCodes billed19
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Indiana
Rank by total paid#13 of 155
Median peer was paid$414K
This provider vs. median9.0×
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 | 13,300 | $73K | |
| 2019 | 17,041 | $544K | |
| 2020 | 16,139 | $513K | |
| 2021 | 21,229 | $688K | |
| 2022 | 20,532 | $668K | |
| 2023 | 18,503 | $585K | |
| 2024incomplete | 16,089 | $661K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 19% | 5,659 | 2,557 | $694K |
| D1120 | Dental cleaning, childProphylaxis - child | 17% | 20,779 | 19,558 | $628K |
| D1206 | Topical application of fluoride varnish | 12% | 22,859 | 21,520 | $436K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 11% | 20,650 | 19,488 | $412K |
| D1351 | Sealant - per tooth | 8.4% | 12,909 | 2,146 | $313K |
| D0272 | Bitewings - two radiographic images | 5.6% | 9,886 | 9,252 | $207K |
| D7140 | Extraction, erupted tooth or exposed root | 5.5% | 2,922 | 1,541 | $205K |
| D0330 | Panoramic radiographic image | 3.5% | 2,403 | 2,264 | $132K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 3.5% | 4,920 | 4,512 | $130K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 3.3% | 1,934 | 1,182 | $122K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 3.2% | 2,740 | 1,578 | $121K |
| D1110 | Prophylaxis - adult | 2.6% | 2,477 | 2,340 | $96K |
7 more codes
| D0140 | Limited oral evaluation - problem focused | 2.1% | 2,449 | $77K |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.9% | 2,520 | $70K |
| D0220 | Intraoral - periapical first radiographic image | <1% | 3,828 | $36K |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 3,130 | $24K |
| D0274 | Bitewings - four radiographic images | <1% | 660 | $17K |
| D1354 | <1% | 94 | $9K | |
| D1510 | <1% | 14 | $2K |
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 officialRASCHE, MATTHEW (OWNER/MEMBER)