Dental
Siouxland Dental Health - South Sioux, LLC
Siouxland Dental Health - South Sioux, LLC was paid $1.76M by Medicaid between Jan 2018 and Dec 2024, across 23 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 16% of everything it billed.
33Billing provider infoSIOUXLAND DENTAL HEALTH - SOUTH SIOUX, LLC
SOUTH SIOUX CITY, NE 68776
SOUTH SIOUX CITY, NE 68776
33aNPI1386981561assigned 01/09/2013
33bProvider typeGeneral Practice Dentistry
28Total paid$1.76M
24GClaims52,948
24DCodes billed23
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in Nebraska
Rank by total paid#7 of 201
Median peer was paid$21K
This provider vs. median83×
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 | 11,442 | $297K | |
| 2019 | 11,202 | $277K | |
| 2020 | 6,804 | $166K | |
| 2021 | 7,272 | $182K | |
| 2022 | 5,981 | $301K | |
| 2023 | 6,711 | $380K | |
| 2024incomplete | 3,536 | $161K |
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 | 16% | 3,054 | 1,910 | $283K |
| D1206 | Topical application of fluoride varnish | 15% | 10,988 | 10,726 | $268K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 15% | 9,723 | 9,622 | $264K |
| D1110 | Prophylaxis - adult | 11% | 4,357 | 4,311 | $195K |
| D1120 | Dental cleaning, childProphylaxis - child | 11% | 5,666 | 5,616 | $191K |
| D1351 | Sealant - per tooth | 9.1% | 5,094 | 1,169 | $160K |
| D0274 | Bitewings - four radiographic images | 5.7% | 3,627 | 3,584 | $101K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 3.4% | 915 | 695 | $60K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.2% | 1,239 | 1,218 | $40K |
| D7140 | Extraction, erupted tooth or exposed root | 2.1% | 770 | 280 | $38K |
| D4910 | 1.5% | 403 | 400 | $26K | |
| D0210 | Intraoral - complete series of radiographic images | 1.4% | 324 | 323 | $25K |
11 more codes
| D0330 | Panoramic radiographic image | 1.4% | 856 | $25K |
| D0220 | Intraoral - periapical first radiographic image | 1.2% | 2,220 | $20K |
| D0272 | Bitewings - two radiographic images | <1% | 1,155 | $16K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | <1% | 263 | $14K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 129 | $11K |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 1,346 | $8K |
| D0140 | Limited oral evaluation - problem focused | <1% | 255 | $6K |
| D1999 | <1% | 516 | $5K | |
| D2740 | Crown - porcelain/ceramic | <1% | 18 | $5K |
| D2331 | <1% | 14 | $1K | |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | <1% | 16 | $1K |
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 officialMCCOMBS, RONEL (CREDENTIALING SPECIALIST)
| Provider | Location | Paid |
|---|---|---|
| Mortenson Family Dental Center - Simpsonville, PLLC | Simpsonville, KY | $719K |
| Loftus Family Dental - Post Falls | Post Falls, ID | $377K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.