Dental
Southern Magnolia Dentistry, LLC
Southern Magnolia Dentistry, LLC was paid $262K by Medicaid between Feb 2024 and Dec 2024, across 18 billing codes. Its largest line is D0150, Comprehensive oral evaluation - new or established patient — 19% of everything it billed.
33Billing provider infoSOUTHERN MAGNOLIA DENTISTRY, LLC
ALEXANDRIA, LA 71301
ALEXANDRIA, LA 71301
33aNPI1598545386assigned 09/29/2023
33bProvider typePediatric Dentist
28Total paid$262K
24GClaims6,044
24DCodes billed18
24AFirst – last monthFeb 2024 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Louisiana
Rank by total paid#62 of 98
Median peer was paid$469K
This provider vs. median0.6×
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 | |
|---|---|---|---|
| 2024incomplete | 6,044 | $262K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0150 | Comprehensive oral evaluation - new or established patient | 19% | 886 | 823 | $51K |
| D0330 | Panoramic radiographic image | 15% | 574 | 537 | $39K |
| D1206 | Topical application of fluoride varnish | 10% | 870 | 824 | $26K |
| D1120 | Dental cleaning, childProphylaxis - child | 9.2% | 563 | 537 | $24K |
| D7140 | Extraction, erupted tooth or exposed root | 8.1% | 285 | 127 | $21K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 6.1% | 395 | 326 | $16K |
| D1110 | Prophylaxis - adult | 5.9% | 290 | 250 | $15K |
| D1351 | Sealant - per tooth | 4.3% | 329 | 84 | $11K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 4.2% | 121 | 95 | $11K |
| D0272 | Bitewings - two radiographic images | 3.8% | 511 | 473 | $10K |
| D0145 | Oral evaluation for a patient under three years of age | 3.2% | 142 | 135 | $8K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 2.8% | 55 | 41 | $7K |
6 more codes
| D0220 | Intraoral - periapical first radiographic image | 2.5% | 430 | $7K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 1.9% | 28 | $5K |
| D0120 | Dental checkup, returning patient | 1.3% | 111 | $4K |
| D0140 | Limited oral evaluation - problem focused | 1.1% | 236 | $3K |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 193 | $2K |
| D0210 | Intraoral - complete series of radiographic images | <1% | 25 | $1K |
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 officialJOHNSON-VALLOT, AKEELE (OWNER)