Dental
Clubhouse Pediatric Dentistry of Idaho Falls
Clubhouse Pediatric Dentistry of Idaho Falls was paid $5K by Medicaid between Feb 2019 and Jul 2019, across 5 billing codes. Its largest line is D0150, Comprehensive oral evaluation - new or established patient — 72% of everything it billed.
33Billing provider infoCLUBHOUSE PEDIATRIC DENTISTRY OF IDAHO FALLS
IDAHO FALLS, ID 83404
IDAHO FALLS, ID 83404
33aNPI1376028324assigned 09/26/2018
33bProvider typePediatric Dentist
28Total paid$5K
24GClaims283
24DCodes billed5
24AFirst – last monthFeb 2019 – Jul 2019
Compared with peers
Next to other Pediatric Dentist providers in Idaho
Rank by total paid#52 of 53
Median peer was paid$394K
This provider vs. median0.0×
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 | |
|---|---|---|---|
| 2019 | 283 | $5K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0150 | Comprehensive oral evaluation - new or established patient | 72% | 60 | 60 | $4K |
| D1120 | Dental cleaning, childProphylaxis - child | 30% | 75 | 75 | $1K |
| D1208 | Topical application of fluoride, excluding varnish | 0% | 26 | 26 | $0.00 |
| D0220 | Intraoral - periapical first radiographic image | 0% | 61 | 57 | $0.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 0% | 61 | 50 | $-88.03 |
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 officialROBISON, JENNIFER (CREDENTIALING COORDINATOR)
| Provider | Location | Paid |
|---|---|---|
| Clubhouse Pediatric Dentistry of Madison | Rexburg, ID | $1.89M |
| Clubhouse Pediatric Dentistry of West Jordan | Midvale, UT | $0.00 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.