Dental
Southridge Dental
Southridge Dental was paid $12K by Medicaid between Jan 2018 and Sep 2020, across 6 billing codes. Its largest line is D1110, Prophylaxis - adult — 98% of everything it billed.
33Billing provider infoSOUTHRIDGE DENTAL
NAMPA, ID 83686
NAMPA, ID 83686
33aNPI1891954343assigned 06/09/2008
33bProvider typeGeneral Practice Dentistry
28Total paid$12K
24GClaims564
24DCodes billed6
24AFirst – last monthJan 2018 – Sep 2020
Compared with peers
Next to other General Practice Dentistry providers in Idaho
Rank by total paid#104 of 173
Median peer was paid$22K
This provider vs. median0.5×
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 | 319 | $6K | |
| 2019 | 146 | $4K | |
| 2020 | 99 | $2K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 98% | 144 | 144 | $12K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 1.6% | 293 | 291 | $182.38 |
| D0220 | Intraoral - periapical first radiographic image | 0% | 27 | 26 | $0.00 |
| D0274 | Bitewings - four radiographic images | 0% | 13 | 13 | $0.00 |
| D1206 | Topical application of fluoride varnish | 0% | 41 | 41 | $0.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 0% | 46 | 25 | $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 officialPRATT, ROBERT (DENTIST)