Dental
South Bend Family Dentistry, P.C.
South Bend Family Dentistry, P.C. was paid $110K by Medicaid between Jan 2018 and Nov 2019, across 16 billing codes. Its largest line is D7210, Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth — 36% of everything it billed.
33Billing provider infoSOUTH BEND FAMILY DENTISTRY, P.C.
SOUTH BEND, IN 46616
SOUTH BEND, IN 46616
33aNPI1841369535assigned 11/07/2006
33bProvider typeGeneral Practice Dentistry
28Total paid$110K
24GClaims4,817
24DCodes billed16
24AFirst – last monthJan 2018 – Nov 2019
Compared with peers
Next to other General Practice Dentistry providers in Indiana
Rank by total paid#298 of 723
Median peer was paid$60K
This provider vs. median1.9×
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 | 2,618 | $15K | |
| 2019 | 2,199 | $95K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 36% | 285 | 125 | $40K |
| D1110 | Prophylaxis - adult | 14% | 549 | 513 | $15K |
| D0140 | Limited oral evaluation - problem focused | 9.1% | 414 | 389 | $10K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 8.2% | 724 | 682 | $9K |
| D0274 | Bitewings - four radiographic images | 6.6% | 441 | 411 | $7K |
| D1208 | Topical application of fluoride, excluding varnish | 6.3% | 609 | 577 | $7K |
| D1120 | Dental cleaning, childProphylaxis - child | 5.0% | 335 | 322 | $5K |
| D0150 | Comprehensive oral evaluation - new or established patient | 4.4% | 286 | 265 | $5K |
| D0220 | Intraoral - periapical first radiographic image | 3.2% | 510 | 478 | $3K |
| D2160 | 3.1% | 69 | 40 | $3K | |
| D4212 | 1.7% | 272 | 108 | $2K | |
| D0330 | Panoramic radiographic image | 1.6% | 43 | 38 | $2K |
4 more codes
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 officialMAI, TRANG (PRESIDENT)