Select Dental Associates PC

Select Dental Associates PC was paid $339K by Medicaid between Apr 2018 and Oct 2023, across 16 billing codes. Its largest line is D1110, Prophylaxis - adult — 25% of everything it billed.

33Billing provider infoSELECT DENTAL ASSOCIATES PC
SOUTH BEND, IN 46613

33aNPI1457850687assigned 02/02/2018

33bProvider typeGeneral Practice Dentistry

28Total paid$339K

24GClaims12,118

24DCodes billed16

24AFirst – last monthApr 2018 – Oct 2023

Compared with peers

Next to other General Practice Dentistry providers in Indiana

Rank by total paid#166 of 723

Median peer was paid$60K

This provider vs. median5.7×

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	1,963	$9K
2019	2,276	$70K
2020	2,164	$79K
2021	2,177	$78K
2022	2,677	$84K
2023	861	$20K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1110	Prophylaxis - adult	25%	2,376	1,902	$84K
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth	16%	351	89	$55K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	13%	2,573	2,060	$44K
D0274	Bitewings - four radiographic images	9.8%	1,298	1,029	$33K
D0150	Comprehensive oral evaluation - new or established patient	7.5%	986	811	$25K
D0140	Limited oral evaluation - problem focused	6.9%	738	620	$24K
D1208	Topical application of fluoride, excluding varnish	6.7%	1,814	1,461	$23K
D1120	Dental cleaning, childProphylaxis - child	5.4%	814	675	$18K
D0210	Intraoral - complete series of radiographic images	4.3%	220	183	$15K
D0330	Panoramic radiographic image	2.5%	188	153	$8K
D0220	Intraoral - periapical first radiographic image	1.0%	466	362	$4K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	<1%	150	80	$3K

4 more codes

D4355		<1%	31	$2K
D2393	Resin-based composite - three surfaces, posterior, primary or permanent	<1%	44	$2K
D0272	Bitewings - two radiographic images	<1%	41	$652.50
D2391	Resin-based composite - one surface, posterior, primary or permanent	0%	28	$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 officialKOSEK, DOUGLAS (OWNER)