Dental
South Jersey Pediatric Dental, LLC
South Jersey Pediatric Dental, LLC was paid $1.94M by Medicaid between Jan 2018 and Mar 2020, across 29 billing codes. Its largest line is D0120, dental checkup, returning patient — 12% of everything it billed.
33Billing provider infoSOUTH JERSEY PEDIATRIC DENTAL, LLC
VINELAND, NJ 08360
VINELAND, NJ 08360
33aNPI1598199101assigned 08/30/2013
33bProvider typeGeneral Practice Dentistry
28Total paid$1.94M
24GClaims47,225
24DCodes billed29
24AFirst – last monthJan 2018 – Mar 2020
Compared with peers
Next to other General Practice Dentistry providers in New Jersey
Rank by total paid#32 of 790
Median peer was paid$43K
This provider vs. median46×
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 | 23,070 | $974K | |
| 2019 | 20,538 | $805K | |
| 2020 | 3,617 | $166K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 12% | 5,360 | 5,359 | $241K |
| D1120 | Dental cleaning, childProphylaxis - child | 12% | 5,176 | 5,176 | $233K |
| D1351 | Sealant - per tooth | 11% | 4,660 | 1,744 | $210K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 11% | 1,882 | 911 | $206K |
| D2150 | Silver amalgam - two surfaces, primary or permanent | 7.3% | 1,296 | 586 | $141K |
| D0272 | Bitewings - two radiographic images | 7.1% | 4,063 | 4,062 | $138K |
| D7140 | Extraction, erupted tooth or exposed root | 6.9% | 1,081 | 569 | $135K |
| D1208 | Topical application of fluoride, excluding varnish | 4.2% | 3,653 | 3,653 | $82K |
| D0220 | Intraoral - periapical first radiographic image | 3.7% | 4,754 | 4,676 | $71K |
| D0230 | Intraoral - periapical each additional radiographic image | 3.6% | 4,438 | 4,411 | $71K |
| D9920 | 3.0% | 1,578 | 1,418 | $58K | |
| D1206 | Topical application of fluoride varnish | 2.8% | 1,716 | 1,716 | $55K |
17 more codes
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 2.7% | 441 | $52K |
| D0330 | Panoramic radiographic image | 2.3% | 594 | $45K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 2.3% | 2,217 | $44K |
| D2160 | 1.9% | 308 | $37K | |
| D0603 | 1.3% | 2,519 | $25K | |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 1.2% | 250 | $24K |
| D0210 | Intraoral - complete series of radiographic images | 1.1% | 291 | $22K |
| D0140 | Limited oral evaluation - problem focused | 1.1% | 462 | $21K |
| D7111 | <1% | 247 | $14K | |
| D2330 | <1% | 68 | $5K | |
| D2932 | <1% | 24 | $5K | |
| D1110 | Prophylaxis - adult | <1% | 54 | $3K |
| D2930 | Prefabricated stainless steel crown - primary tooth | <1% | 23 | $3K |
| D2331 | <1% | 28 | $3K | |
| D2332 | <1% | 18 | $2K | |
| D9430 | <1% | 12 | $295.00 | |
| D0602 | <1% | 12 | $120.00 |
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 officialBRISTOL MARTIR, BRENDALIZ (PEDIATRIC DENTIST)