Clinic
Independence Avenue Dental LLC
Independence Avenue Dental LLC was paid $9K by Medicaid between Mar 2018 and May 2019, across 5 billing codes. Its largest line is D0274, Bitewings - four radiographic images — 36% of everything it billed.
33Billing provider infoINDEPENDENCE AVENUE DENTAL LLC
INDEPENDENCE, MO 64050
INDEPENDENCE, MO 64050
33aNPI1396982468assigned 01/12/2009
33bProvider typeDental Clinic/Center
28Total paid$9K
24GClaims294
24DCodes billed5
24AFirst – last monthMar 2018 – May 2019
Compared with peers
Next to other Dental Clinic/Center providers in Missouri
Rank by total paid#15 of 27
Median peer was paid$9K
This provider vs. median1.0×
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 | 190 | $7K | |
| 2019 | 104 | $2K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0274 | Bitewings - four radiographic images | 36% | 166 | 163 | $3K |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 33% | 38 | 14 | $3K |
| D0150 | Comprehensive oral evaluation - new or established patient | 26% | 64 | 61 | $2K |
| D1110 | Prophylaxis - adult | 3.5% | 14 | 14 | $305.40 |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 2.6% | 12 | 12 | $232.00 |
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 officialSILVER, RANDAL (OWNER)