Agency
South Lane Children's Dental Clinic
South Lane Children's Dental Clinic was paid $35K by Medicaid between Jan 2018 and Feb 2024, across 9 billing codes. Its largest line is D1351, Sealant - per tooth — 47% of everything it billed.
33Billing provider infoSOUTH LANE CHILDREN'S DENTAL CLINIC
COTTAGE GROVE, OR 97424
COTTAGE GROVE, OR 97424
33aNPI1497190821assigned 04/29/2013
33bProvider typeVoluntary or Charitable Agency
28Total paid$35K
24GClaims4,985
24DCodes billed9
24AFirst – last monthJan 2018 – Feb 2024
Compared with peers
Next to other Voluntary or Charitable Agency providers in Oregon
Rank by total paid#5 of 6
Median peer was paid$43K
This provider vs. median0.8×
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 | 1,919 | $14K | |
| 2019 | 709 | $5K | |
| 2020 | 410 | $3K | |
| 2021 | 298 | $456.29 | |
| 2022 | 961 | $7K | |
| 2023 | 535 | $4K | |
| 2024incomplete | 153 | $1K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1351 | Sealant - per tooth | 47% | 1,398 | 313 | $17K |
| D1206 | Topical application of fluoride varnish | 19% | 625 | 593 | $7K |
| D0191 | 19% | 649 | 631 | $7K | |
| D0601 | 10.0% | 296 | 288 | $3K | |
| D0603 | 4.7% | 158 | 146 | $2K | |
| D1310 | 0% | 719 | 684 | $0.00 | |
| D1320 | 0% | 390 | 367 | $0.00 | |
| D1330 | 0% | 733 | 695 | $0.00 | |
| D0602 | 0% | 17 | 16 | $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 officialLONG, COURTNEY (DENTAL CARE COORDINATOR)
Parent organizationSOUTH LANE SCHOOL DISTRICT