Dental
Rochester Pediatric Dentistry LLC
Rochester Pediatric Dentistry LLC was paid $11.64M by Medicaid between Jan 2018 and Dec 2024, across 31 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 30% of everything it billed.
33Billing provider infoROCHESTER PEDIATRIC DENTISTRY LLC
ROCHESTER, MN 55904
ROCHESTER, MN 55904
33aNPI1609272822assigned 11/16/2014
33bProvider typePediatric Dentist
28Total paid$11.64M
24GClaims202,076
24DCodes billed31
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Minnesota
Rank by total paid#1 of 49
Median peer was paid$94K
This provider vs. median124×
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 | 22,423 | $205K | |
| 2019 | 28,694 | $1.49M | |
| 2020 | 22,868 | $1.24M | |
| 2021 | 30,766 | $1.73M | |
| 2022 | 32,527 | $2.45M | |
| 2023 | 31,626 | $2.26M | |
| 2024incomplete | 33,172 | $2.26M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 30% | 17,917 | 5,872 | $3.46M |
| D1120 | Dental cleaning, childProphylaxis - child | 9.2% | 24,071 | 23,931 | $1.07M |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 7.2% | 20,663 | 20,556 | $838K |
| D1354 | 6.8% | 22,016 | 7,939 | $792K | |
| D1206 | Topical application of fluoride varnish | 6.5% | 23,980 | 23,808 | $752K |
| D7140 | Extraction, erupted tooth or exposed root | 5.7% | 6,100 | 3,334 | $664K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 5.0% | 6,187 | 3,689 | $584K |
| D1351 | Sealant - per tooth | 4.0% | 11,479 | 4,124 | $461K |
| D0272 | Bitewings - two radiographic images | 3.9% | 13,031 | 12,938 | $448K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 3.2% | 4,838 | 3,254 | $372K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.6% | 6,050 | 6,014 | $305K |
| D0330 | Panoramic radiographic image | 2.4% | 2,798 | 2,786 | $275K |
19 more codes
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 2.3% | 11,787 | $265K |
| D2934 | 2.2% | 1,038 | $262K | |
| D0220 | Intraoral - periapical first radiographic image | 1.6% | 8,334 | $186K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 1.5% | 1,962 | $178K |
| D0230 | Intraoral - periapical each additional radiographic image | 1.3% | 8,808 | $153K |
| D0140 | Limited oral evaluation - problem focused | 1.0% | 2,295 | $121K |
| D1330 | <1% | 2,621 | $107K | |
| D1110 | Prophylaxis - adult | <1% | 1,289 | $77K |
| D1510 | <1% | 282 | $59K | |
| D9920 | <1% | 1,125 | $58K | |
| D0274 | Bitewings - four radiographic images | <1% | 777 | $42K |
| D9420 | <1% | 1,002 | $42K | |
| D2330 | <1% | 378 | $30K | |
| D0170 | <1% | 267 | $17K | |
| D2331 | <1% | 163 | $8K | |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 211 | $5K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 37 | $4K |
| D1353 | <1% | 556 | $141.35 | |
| D1208 | Topical application of fluoride, excluding varnish | 0% | 14 | $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 officialJONES, KELLY (PEDIATRIC DENTIST, OWNER)
| Provider | Location | Paid |
|---|---|---|
| Malbis Parkway Pediatric Dentistry | Daphne, AL | $2.19M |
| Sherman Oaks Mental Health Group GP | Sherman Oaks, CA | $28K |
| Center for Emotional Wellness, PC | Decatur, TX | $349.56 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.