Dental
Pediatric Dentistry of Shelbyville
Pediatric Dentistry of Shelbyville was paid $919K by Medicaid between Jan 2018 and Jan 2024, across 24 billing codes. Its largest line is D1120, dental cleaning, child — 22% of everything it billed.
33Billing provider infoPEDIATRIC DENTISTRY OF SHELBYVILLE
SHELBYVILLE, KY 40065
SHELBYVILLE, KY 40065
33aNPI1770748790assigned 07/21/2008
33bProvider typeGeneral Practice Dentistry
28Total paid$919K
24GClaims31,531
24DCodes billed24
24AFirst – last monthJan 2018 – Jan 2024
Compared with peers
Next to other General Practice Dentistry providers in Kentucky
Rank by total paid#38 of 462
Median peer was paid$106K
This provider vs. median8.7×
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 | 14,785 | $417K | |
| 2019 | 13,969 | $409K | |
| 2020 | 967 | $28K | |
| 2023 | 1,740 | $62K | |
| 2024incomplete | 70 | $2K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 22% | 4,574 | 4,423 | $204K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 18% | 2,524 | 1,103 | $166K |
| D1206 | Topical application of fluoride varnish | 8.4% | 5,372 | 5,204 | $77K |
| D0150 | Comprehensive oral evaluation - new or established patient | 7.9% | 2,909 | 2,826 | $73K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 5.8% | 1,594 | 1,522 | $53K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 5.2% | 2,577 | 2,507 | $48K |
| D0330 | Panoramic radiographic image | 4.9% | 1,185 | 1,160 | $45K |
| D1110 | Prophylaxis - adult | 4.0% | 814 | 790 | $37K |
| D1351 | Sealant - per tooth | 3.9% | 2,410 | 735 | $36K |
| D0272 | Bitewings - two radiographic images | 3.7% | 1,966 | 1,906 | $34K |
| D7140 | Extraction, erupted tooth or exposed root | 3.6% | 700 | 356 | $33K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 3.0% | 529 | 323 | $28K |
12 more codes
| D0274 | Bitewings - four radiographic images | 2.1% | 710 | $19K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 1.8% | 148 | $17K |
| D0220 | Intraoral - periapical first radiographic image | 1.5% | 1,501 | $14K |
| D0140 | Limited oral evaluation - problem focused | 1.1% | 379 | $10K |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 1,373 | $9K |
| D9248 | <1% | 85 | $7K | |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | <1% | 73 | $5K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 39 | $3K |
| D9420 | <1% | 15 | $743.60 | |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 26 | $513.25 |
| D0350 | 0% | 13 | $0.00 | |
| D9986 | 0% | 15 | $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 officialRAISOR, AMY (OFFICE MANAGER)