Dental
Jeffersonville Pediatric Dentistry LLC
Jeffersonville Pediatric Dentistry LLC was paid $2.66M by Medicaid between Sep 2022 and Dec 2024, across 24 billing codes. Its largest line is D0120, dental checkup, returning patient — 10% of everything it billed.
33Billing provider infoJEFFERSONVILLE PEDIATRIC DENTISTRY LLC
JEFFERSONVILLE, IN 47130
JEFFERSONVILLE, IN 47130
33aNPI1548917982assigned 03/06/2022
33bProvider typePediatric Dentist
28Total paid$2.66M
24GClaims73,864
24DCodes billed24
24AFirst – last monthSep 2022 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Indiana
Rank by total paid#25 of 155
Median peer was paid$414K
This provider vs. median6.4×
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 | |
|---|---|---|---|
| 2022 | 7,626 | $229K | |
| 2023 | 29,826 | $1.04M | |
| 2024incomplete | 36,412 | $1.38M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 10% | 11,803 | 11,353 | $277K |
| D1120 | Dental cleaning, childProphylaxis - child | 10% | 7,581 | 7,296 | $275K |
| D1110 | Prophylaxis - adult | 9.6% | 5,261 | 5,062 | $254K |
| D1206 | Topical application of fluoride varnish | 9.2% | 10,930 | 10,501 | $244K |
| D1351 | Sealant - per tooth | 8.4% | 7,525 | 1,206 | $222K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 7.7% | 1,395 | 719 | $203K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 5.6% | 1,903 | 1,012 | $148K |
| D7140 | Extraction, erupted tooth or exposed root | 5.5% | 1,643 | 921 | $146K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 4.9% | 1,250 | 667 | $131K |
| D1354 | 3.8% | 1,583 | 566 | $100K | |
| D0330 | Panoramic radiographic image | 3.3% | 1,778 | 1,703 | $87K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 2.7% | 2,497 | 2,155 | $72K |
12 more codes
| D0272 | Bitewings - two radiographic images | 2.6% | 3,078 | $69K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 2.6% | 1,122 | $69K |
| D0274 | Bitewings - four radiographic images | 1.9% | 1,624 | $51K |
| D0230 | Intraoral - periapical each additional radiographic image | 1.9% | 4,566 | $49K |
| D0220 | Intraoral - periapical first radiographic image | 1.8% | 3,791 | $48K |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.6% | 1,026 | $41K |
| D0140 | Limited oral evaluation - problem focused | 1.3% | 945 | $34K |
| D9920 | 1.2% | 666 | $31K | |
| D1510 | 1.1% | 226 | $30K | |
| D0210 | Intraoral - complete series of radiographic images | 1.1% | 1,286 | $30K |
| D9248 | <1% | 242 | $25K | |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 143 | $18K |
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 officialCOMBS, PORCHUSA (PEDIATRIC DENTIST)