Dental
Southside Children's Dental Center, P.C.
Southside Children's Dental Center, P.C. was paid $12.80M by Medicaid between Jan 2018 and Dec 2024, across 37 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 12% of everything it billed.
33Billing provider infoSOUTHSIDE CHILDREN'S DENTAL CENTER, P.C.
SAN ANTONIO, TX 78221
SAN ANTONIO, TX 78221
33aNPI1902815335assigned 08/05/2006
33bProvider typeGeneral Practice Dentistry
28Total paid$12.80M
24GClaims405,440
24DCodes billed37
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in Texas
Rank by total paid#2 of 2,774
Median peer was paid$43K
This provider vs. median300×
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 | 828 | $14K | |
| 2019 | 689 | $10K | |
| 2020 | 9,184 | $299K | |
| 2021 | 90,713 | $2.84M | |
| 2022 | 108,114 | $3.29M | |
| 2023 | 106,536 | $3.42M | |
| 2024incomplete | 89,376 | $2.92M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 12% | 11,519 | 3,561 | $1.56M |
| D1351 | Sealant - per tooth | 11% | 56,021 | 10,133 | $1.39M |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 11% | 50,090 | 49,496 | $1.39M |
| D1120 | Dental cleaning, childProphylaxis - child | 9.4% | 34,392 | 33,991 | $1.21M |
| D1110 | Prophylaxis - adult | 7.2% | 17,756 | 17,506 | $917K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 6.7% | 8,846 | 5,037 | $859K |
| D0145 | Oral evaluation for a patient under three years of age | 6.3% | 5,849 | 5,787 | $808K |
| D1208 | Topical application of fluoride, excluding varnish | 5.5% | 49,366 | 48,785 | $702K |
| D9248 | 4.9% | 5,517 | 5,388 | $621K | |
| D0272 | Bitewings - two radiographic images | 3.9% | 24,933 | 24,520 | $504K |
| D0274 | Bitewings - four radiographic images | 3.8% | 16,882 | 16,595 | $488K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 3.3% | 5,504 | 2,345 | $424K |
25 more codes
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 2.2% | 3,813 | $281K |
| D0210 | Intraoral - complete series of radiographic images | 2.2% | 4,161 | $278K |
| D7240 | Removal of impacted tooth - completely bony | 2.1% | 958 | $263K |
| D0330 | Panoramic radiographic image | 2.0% | 9,156 | $255K |
| D0220 | Intraoral - periapical first radiographic image | 1.2% | 15,176 | $157K |
| D7140 | Extraction, erupted tooth or exposed root | 1.1% | 2,864 | $143K |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 3,521 | $115K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 1,078 | $105K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | <1% | 3,427 | $84K |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 7,549 | $67K |
| D0140 | Limited oral evaluation - problem focused | <1% | 2,478 | $45K |
| D9223 | Deep sedation/general anesthesia - each subsequent 15 minute increment | <1% | 728 | $28K |
| D9222 | <1% | 369 | $21K | |
| D1206 | Topical application of fluoride varnish | <1% | 1,437 | $20K |
| D9420 | <1% | 503 | $17K | |
| D2934 | <1% | 126 | $17K | |
| D9612 | <1% | 344 | $9K | |
| D0170 | <1% | 395 | $6K | |
| D2332 | <1% | 46 | $5K | |
| D9310 | <1% | 225 | $2K | |
| D0270 | <1% | 321 | $1K | |
| D7111 | <1% | 113 | $1K | |
| D0367 | <1% | 12 | $1K | |
| D0240 | <1% | 15 | $107.80 | |
| D0603 | 0% | 59,950 | $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 officialCODERRE-ZERCHER, DORIS (OFFICE MANAGER)