Dental
Pediatric Dentistry of Chattanooga, PLLC
Pediatric Dentistry of Chattanooga, PLLC was paid $398K by Medicaid between Jan 2018 and Sep 2019, across 14 billing codes. Its largest line is D1120, dental cleaning, child — 23% of everything it billed.
33Billing provider infoPEDIATRIC DENTISTRY OF CHATTANOOGA, PLLC
CLEVELAND, TN 37312
CLEVELAND, TN 37312
33aNPI1851655187assigned 07/02/2012
33bProvider typeGeneral Practice Dentistry
28Total paid$398K
24GClaims13,696
24DCodes billed14
24AFirst – last monthJan 2018 – Sep 2019
Compared with peers
Next to other General Practice Dentistry providers in Tennessee
Rank by total paid#100 of 336
Median peer was paid$123K
This provider vs. median3.2×
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 | 8,600 | $242K | |
| 2019 | 5,096 | $156K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 23% | 3,013 | 2,978 | $90K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 18% | 3,275 | 3,247 | $72K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 17% | 704 | 242 | $68K |
| D1206 | Topical application of fluoride varnish | 14% | 3,138 | 3,085 | $58K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 6.8% | 432 | 218 | $27K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 5.5% | 319 | 108 | $22K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 4.3% | 615 | 599 | $17K |
| D0272 | Bitewings - two radiographic images | 3.8% | 965 | 955 | $15K |
| D7140 | Extraction, erupted tooth or exposed root | 2.5% | 171 | 79 | $10K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 1.7% | 118 | 63 | $7K |
| D0220 | Intraoral - periapical first radiographic image | 1.4% | 498 | 490 | $6K |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 122 | 118 | $3K |
2 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 officialMAYNOR, SOMMER (CREDENTIALING MGR)