Clinic
Southside Dental Cares, PC
Southside Dental Cares, PC was paid $14K by Medicaid between Jun 2022 and Jul 2024, across 9 billing codes. Its largest line is D1206, Topical application of fluoride varnish — 25% of everything it billed.
33Billing provider infoSOUTHSIDE DENTAL CARES, PC
PETERSBURG, VA 23805
PETERSBURG, VA 23805
33aNPI1962154252assigned 01/19/2022
33bProvider typeDental Clinic/Center
28Total paid$14K
24GClaims775
24DCodes billed9
24AFirst – last monthJun 2022 – Jul 2024
Compared with peers
Next to other Dental Clinic/Center providers in Virginia
Rank by total paid#96 of 142
Median peer was paid$75K
This provider vs. median0.2×
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 | |
|---|---|---|---|
| 2022 | 396 | $9K | |
| 2023 | 341 | $5K | |
| 2024incomplete | 38 | $0.00 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1206 | Topical application of fluoride varnish | 25% | 208 | 205 | $3K |
| D9630 | 24% | 202 | 199 | $3K | |
| D1110 | Prophylaxis - adult | 16% | 63 | 63 | $2K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 9.5% | 92 | 92 | $1K |
| D0230 | Intraoral - periapical each additional radiographic image | 7.0% | 80 | 41 | $987.83 |
| D0150 | Comprehensive oral evaluation - new or established patient | 6.4% | 25 | 25 | $904.82 |
| D0274 | Bitewings - four radiographic images | 5.8% | 27 | 27 | $825.24 |
| D0220 | Intraoral - periapical first radiographic image | 3.7% | 66 | 66 | $516.42 |
| D1120 | Dental cleaning, childProphylaxis - child | 2.8% | 12 | 12 | $402.24 |
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 officialHEPNER, BARBARA (MANAGER)