Clinic
Blytheville Pediatric Dentistry, PLLC
Blytheville Pediatric Dentistry, PLLC was paid $863K by Medicaid between Jan 2018 and Nov 2021, across 20 billing codes. Its largest line is D0120, dental checkup, returning patient — 21% of everything it billed.
33Billing provider infoBLYTHEVILLE PEDIATRIC DENTISTRY, PLLC
BLYTHEVILLE, AR 72315
BLYTHEVILLE, AR 72315
33aNPI1891123279assigned 10/23/2013
33bProvider typeDental Clinic/Center
28Total paid$863K
24GClaims35,010
24DCodes billed20
24AFirst – last monthJan 2018 – Nov 2021
Compared with peers
Next to other Dental Clinic/Center providers in Arkansas
Rank by total paid#12 of 117
Median peer was paid$43K
This provider vs. median20×
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 | 7,843 | $162K | |
| 2019 | 5,930 | $147K | |
| 2020 | 8,652 | $223K | |
| 2021 | 12,585 | $331K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 21% | 7,442 | 7,063 | $179K |
| D1120 | Dental cleaning, childProphylaxis - child | 20% | 5,450 | 5,158 | $174K |
| D0272 | Bitewings - two radiographic images | 14% | 5,662 | 5,414 | $119K |
| D1208 | Topical application of fluoride, excluding varnish | 12% | 5,757 | 5,498 | $103K |
| D1110 | Prophylaxis - adult | 8.6% | 1,691 | 1,632 | $74K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 4.7% | 1,749 | 1,631 | $41K |
| D1206 | Topical application of fluoride varnish | 3.1% | 1,390 | 1,301 | $27K |
| D0210 | Intraoral - complete series of radiographic images | 2.9% | 317 | 301 | $25K |
| D9248 | 2.7% | 300 | 262 | $23K | |
| D2930 | Prefabricated stainless steel crown - primary tooth | 2.5% | 163 | 101 | $22K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 2.0% | 321 | 177 | $18K |
| D1351 | Sealant - per tooth | 2.0% | 663 | 169 | $17K |
8 more codes
| D2150 | Silver amalgam - two surfaces, primary or permanent | 1.3% | 143 | $11K |
| D0220 | Intraoral - periapical first radiographic image | 1.1% | 592 | $10K |
| D0603 | 1.1% | 2,286 | $9K | |
| D0140 | Limited oral evaluation - problem focused | <1% | 161 | $5K |
| D0602 | <1% | 755 | $3K | |
| D0330 | Panoramic radiographic image | <1% | 140 | $2K |
| D2140 | <1% | 15 | $983.25 | |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 13 | $866.40 |
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 officialBURROWS, JAMMIE (OFFICE MANAGER)