Dental
Southbridge Medical Advisory Council INC
Southbridge Medical Advisory Council INC was paid $2.17M by Medicaid between Jan 2018 and Nov 2024, across 30 billing codes. Its largest line is G0467, community health center visit, returning patient — 85% of everything it billed.
33Billing provider infoSOUTHBRIDGE MEDICAL ADVISORY COUNCIL INC
WILMINGTON, DE 19801
WILMINGTON, DE 19801
33aNPI1770699621assigned 08/22/2006
33bProvider typeDentist
28Total paid$2.17M
24GClaims33,818
24DCodes billed30
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Dentist providers in Delaware
Rank by total paid#10 of 55
Median peer was paid$204K
This provider vs. median11×
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 | 4,738 | $96K | |
| 2019 | 4,034 | $194K | |
| 2020 | 2,336 | $184K | |
| 2021 | 3,803 | $377K | |
| 2022 | 4,776 | $351K | |
| 2023 | 9,226 | $625K | |
| 2024incomplete | 4,905 | $341K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| G0467 | Community health center visit, returning patientFederally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit | 85% | 12,692 | 8,214 | $1.85M |
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 7.7% | 4,925 | 4,060 | $168K |
| G0466 | Community health center visit, new patientFederally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit | 5.8% | 919 | 602 | $125K |
| G0470 | Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit | <1% | 96 | 60 | $13K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | <1% | 5,216 | 3,532 | $3K |
| D1110 | Prophylaxis - adult | <1% | 45 | 39 | $3K |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | <1% | 4,539 | 3,098 | $3K |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 26 | 26 | $2K |
| D0330 | Panoramic radiographic image | <1% | 13 | 13 | $1K |
| D0140 | Limited oral evaluation - problem focused | <1% | 13 | 13 | $658.80 |
| D0220 | Intraoral - periapical first radiographic image | <1% | 27 | 27 | $607.56 |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | <1% | 16 | 15 | $606.34 |
18 more codes
| D1208 | Topical application of fluoride, excluding varnish | <1% | 14 | $344.28 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 785 | $214.50 |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 279 | $96.89 |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 741 | $96.70 |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 79 | $45.00 |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 39 | $26.01 |
| 81025 | <1% | 197 | $17.07 | |
| 99173 | <1% | 799 | $16.03 | |
| 82962 | <1% | 1,646 | $8.65 | |
| 81002 | <1% | 352 | $0.15 | |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 16 | $0.02 |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 27 | $0.01 |
| D1330 | 0% | 26 | $0.00 | |
| 0011A | 0% | 54 | $0.00 | |
| 91301 | 0% | 141 | $0.00 | |
| 0012A | 0% | 46 | $0.00 | |
| 92552 | 0% | 24 | $0.00 | |
| 99442 | 0% | 26 | $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 officialRIVERA, ROSA (CHIEF EXECUTIVE OFFICER)
| Provider | Location | Paid |
|---|---|---|
| Southbridge Medical Advisory Council INC | Wilmington, DE | $125K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.