Create-A-Smile, PC

Create-A-Smile, PC was paid $95K by Medicaid between Jan 2018 and Nov 2024, across 9 billing codes. Its largest line is D1110, Prophylaxis - adult — 35% of everything it billed.

33Billing provider infoCREATE-A-SMILE, PC
BLOOMINGTON, IN 47404

33aNPI1588995229assigned 01/20/2010

33bProvider typeDentist

28Total paid$95K

24GClaims4,050

24DCodes billed9

24AFirst – last monthJan 2018 – Nov 2024

Compared with peers

Next to other Dentist providers in Indiana

Rank by total paid#200 of 452

Median peer was paid$59K

This provider vs. median1.6×

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	638	$5K
2019	689	$17K
2020	408	$10K
2021	683	$18K
2022	940	$25K
2023	433	$12K
2024incomplete	259	$8K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1110	Prophylaxis - adult	35%	914	852	$34K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	26%	1,336	1,242	$24K
D1206	Topical application of fluoride varnish	23%	1,256	1,169	$22K
D0274	Bitewings - four radiographic images	8.5%	284	269	$8K
D1120	Dental cleaning, childProphylaxis - child	4.7%	173	160	$4K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	1.1%	20	14	$1K
D0210	Intraoral - complete series of radiographic images	<1%	18	13	$939.25
D2391	Resin-based composite - one surface, posterior, primary or permanent	<1%	34	12	$444.00
D9230	Inhalation of nitrous oxide / analgesia, anxiolysis	<1%	15	13	$432.06

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 officialMOORE, SHANNON (OWNER)