Dental
Kothapalli, Samantha
Kothapalli, Samantha was paid $409K by Medicaid between Jan 2018 and Sep 2021, across 13 billing codes. Its largest line is D1120, dental cleaning, child — 28% of everything it billed.
33Billing provider infoKOTHAPALLI, SAMANTHA
SHOREWOOD, IL 60431
SHOREWOOD, IL 60431
33aNPI1902927825assigned 04/02/2007
33bProvider typeGeneral Practice Dentistry
28Total paid$409K
24GClaims13,722
24DCodes billed13
24AFirst – last monthJan 2018 – Sep 2021
Compared with peers
Next to other General Practice Dentistry providers in Illinois
Rank by total paid#297 of 1,017
Median peer was paid$123K
This provider vs. median3.3×
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 | 4,374 | $165K | |
| 2019 | 4,586 | $128K | |
| 2020 | 2,903 | $71K | |
| 2021 | 1,859 | $46K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 28% | 2,902 | 2,766 | $115K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 17% | 2,588 | 2,464 | $70K |
| D1208 | Topical application of fluoride, excluding varnish | 17% | 2,743 | 2,613 | $69K |
| D8670 | Periodic orthodontic treatment visit | 12% | 211 | 204 | $48K |
| D1351 | Sealant - per tooth | 8.7% | 661 | 313 | $35K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 7.4% | 464 | 311 | $30K |
| D0274 | Bitewings - four radiographic images | 3.7% | 920 | 879 | $15K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 1.8% | 192 | 143 | $7K |
| D0220 | Intraoral - periapical first radiographic image | 1.7% | 1,262 | 1,193 | $7K |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.1% | 227 | 220 | $5K |
| D0230 | Intraoral - periapical each additional radiographic image | 1.1% | 1,202 | 1,131 | $4K |
| D0272 | Bitewings - two radiographic images | <1% | 336 | 328 | $3K |
1 more codes
| D0330 | Panoramic radiographic image | <1% | 14 | $293.70 |
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.