Dental
Universal Dental Assoc Dso LLC
Universal Dental Assoc Dso LLC was paid $56K by Medicaid between Jan 2018 and Jan 2019, across 10 billing codes. Its largest line is D1110, Prophylaxis - adult — 35% of everything it billed.
33Billing provider infoUNIVERSAL DENTAL ASSOC DSO LLC
JOHNSON CITY, TN 37604
JOHNSON CITY, TN 37604
33aNPI1467758227assigned 01/26/2011
33bProvider typeDentist
28Total paid$56K
24GClaims2,132
24DCodes billed10
24AFirst – last monthJan 2018 – Jan 2019
Compared with peers
Next to other Dentist providers in Tennessee
Rank by total paid#176 of 242
Median peer was paid$164K
This provider vs. median0.3×
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 | 2,120 | $55K | |
| 2019 | 12 | $482.68 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 35% | 517 | 513 | $19K |
| D0274 | Bitewings - four radiographic images | 14% | 319 | 318 | $8K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 12% | 296 | 296 | $7K |
| D1208 | Topical application of fluoride, excluding varnish | 12% | 364 | 359 | $6K |
| D1120 | Dental cleaning, childProphylaxis - child | 10% | 201 | 200 | $6K |
| D0330 | Panoramic radiographic image | 9.6% | 198 | 197 | $5K |
| D0150 | Comprehensive oral evaluation - new or established patient | 6.5% | 132 | 130 | $4K |
| D0220 | Intraoral - periapical first radiographic image | 1.1% | 62 | 62 | $598.87 |
| D0272 | Bitewings - two radiographic images | <1% | 28 | 27 | $433.90 |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 15 | 12 | $117.00 |
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 officialLANGENBRUNNER, TONYA (OFFICE MANAGER)