Dental
Eastern Indiana Pediatric Dentistry, LLC
Eastern Indiana Pediatric Dentistry, LLC was paid $25K by Medicaid between Jan 2018 and Dec 2019, across 5 billing codes. Its largest line is D1120, dental cleaning, child — 36% of everything it billed.
33Billing provider infoEASTERN INDIANA PEDIATRIC DENTISTRY, LLC
CONNERSVILLE, IN 47331
CONNERSVILLE, IN 47331
33aNPI1760616114assigned 05/13/2009
33bProvider typePediatric Dentist
28Total paid$25K
24GClaims2,089
24DCodes billed5
24AFirst – last monthJan 2018 – Dec 2019
Compared with peers
Next to other Pediatric Dentist providers in Indiana
Rank by total paid#115 of 155
Median peer was paid$414K
This provider vs. median0.1×
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 | 925 | $5K | |
| 2019 | 1,164 | $20K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 36% | 593 | 503 | $9K |
| D1206 | Topical application of fluoride varnish | 29% | 742 | 634 | $7K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 26% | 666 | 553 | $6K |
| D1110 | Prophylaxis - adult | 4.4% | 27 | 24 | $1K |
| D0272 | Bitewings - two radiographic images | 3.7% | 61 | 60 | $917.97 |
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 officialPOLAND, CHARLES (MEMBER)