Dental
The Dental Center of South Bend LLC
The Dental Center of South Bend LLC was paid $15.83M by Medicaid between Jan 2018 and Dec 2024, across 40 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 13% of everything it billed.
33Billing provider infoTHE DENTAL CENTER OF SOUTH BEND LLC
SOUTH BEND, IN 46617
SOUTH BEND, IN 46617
33aNPI1538184460assigned 07/13/2006
33bProvider typePediatric Dentist
28Total paid$15.83M
24GClaims497,732
24DCodes billed40
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Indiana
Rank by total paid#1 of 155
Median peer was paid$414K
This provider vs. median38×
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 | 75,774 | $279K | |
| 2019 | 78,774 | $2.97M | |
| 2020 | 57,619 | $2.01M | |
| 2021 | 75,244 | $2.74M | |
| 2022 | 78,976 | $2.84M | |
| 2023 | 70,615 | $2.32M | |
| 2024incomplete | 60,730 | $2.67M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 13% | 16,042 | 6,119 | $2.02M |
| D1120 | Dental cleaning, childProphylaxis - child | 9.1% | 49,392 | 47,040 | $1.43M |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 8.1% | 65,861 | 62,740 | $1.28M |
| D1206 | Topical application of fluoride varnish | 7.9% | 63,139 | 60,128 | $1.24M |
| D1351 | Sealant - per tooth | 7.0% | 48,081 | 9,400 | $1.11M |
| D0272 | Bitewings - two radiographic images | 6.7% | 56,313 | 53,508 | $1.05M |
| D1110 | Prophylaxis - adult | 6.6% | 25,617 | 24,422 | $1.04M |
| D7140 | Extraction, erupted tooth or exposed root | 6.3% | 14,511 | 7,162 | $1.00M |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 5.8% | 16,347 | 11,482 | $922K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 5.4% | 19,283 | 12,539 | $857K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 4.7% | 29,169 | 25,959 | $749K |
| D0210 | Intraoral - complete series of radiographic images | 3.4% | 13,123 | 11,175 | $535K |
28 more codes
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 2.8% | 5,558 | $450K |
| D2934 | 2.2% | 3,149 | $354K | |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.9% | 9,895 | $303K |
| D0140 | Limited oral evaluation - problem focused | 1.8% | 9,297 | $287K |
| D2330 | 1.3% | 3,379 | $214K | |
| D2332 | 1.1% | 1,967 | $166K | |
| D0240 | 1.0% | 13,636 | $163K | |
| D0330 | Panoramic radiographic image | <1% | 8,545 | $156K |
| D1354 | <1% | 1,724 | $108K | |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 1,329 | $90K |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 6,891 | $67K |
| D0220 | Intraoral - periapical first radiographic image | <1% | 6,523 | $62K |
| D2940 | <1% | 1,027 | $50K | |
| D3230 | <1% | 354 | $29K | |
| D2335 | <1% | 263 | $27K | |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | <1% | 109 | $20K |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 2,993 | $15K |
| D0270 | <1% | 913 | $14K | |
| D7111 | <1% | 131 | $8K | |
| D2331 | <1% | 54 | $3K | |
| D4346 | <1% | 13 | $2K | |
| D1515 | <1% | 58 | $1K | |
| D2920 | <1% | 14 | $58.27 | |
| D3120 | 0% | 2,364 | $0.00 | |
| D9420 | 0% | 88 | $0.00 | |
| D9215 | 0% | 75 | $0.00 | |
| D1352 | 0% | 23 | $0.00 | |
| D1999 | 0% | 482 | $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 officialROSENBAUM, CHARLES (DENTALDIRECTOR)