Dental
Southmoor Pediatric Dentistry
Southmoor Pediatric Dentistry was paid $1K by Medicaid between Mar 2018 and Feb 2021, across 3 billing codes. Its largest line is D1206, Topical application of fluoride varnish — 42% of everything it billed.
33Billing provider infoSOUTHMOOR PEDIATRIC DENTISTRY
DENVER, CO 80224
DENVER, CO 80224
33aNPI1811972094assigned 12/12/2005
33bProvider typePediatric Dentist
28Total paid$1K
24GClaims91
24DCodes billed3
24AFirst – last monthMar 2018 – Feb 2021
Compared with peers
Next to other Pediatric Dentist providers in Colorado
Rank by total paid#170 of 177
Median peer was paid$122K
This provider vs. median0.0×
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 | 27 | $643.48 | |
| 2020 | 13 | $200.97 | |
| 2021 | 51 | $590.40 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1206 | Topical application of fluoride varnish | 42% | 42 | 37 | $600.60 |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 41% | 33 | 28 | $593.77 |
| D1120 | Dental cleaning, childProphylaxis - child | 17% | 16 | 12 | $240.48 |
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 officialSMITH, BRADLEY (PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| Rush Memorial Hospital | Rushville, IN | $10.69M |
| SFCDP LLC. | Fort Collins, CO | $2.71M |
| Bradley W. Smith, D.O., PLLC | Pueblo, CO | $1.19M |
| Premier Pediatrics, LLC | Newark, DE | $876K |
| Valudental Walzem1 PLLC | Windcrest, TX | $263K |
| Greenfield Township Trustees | Carroll, OH | $45K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.