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    OpenPayerNPI Medicare & MedicaidSummit Dental Health - Blondo LLC
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    Summit Dental Health - Blondo LLC — Billing Profile & Reimbursement Data

    NPI 1124418892 · Omaha, NE · General Practice Dentistry

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    Summit Dental Health - Blondo LLC is a general practice dentistry provider located in Omaha, Nebraska. This profile covers 0 Medicare and 22 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationSummit Dental Health - Blondo LLC
    Address2005 N 90th St
    CityOmaha
    StateNE
    ZIP68134
    TaxonomyGeneral Practice Dentistry
    NPI EnumeratedFebruary 2, 2015

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$2.2M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

    Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

    22 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    D2392Post 2 surface resin‑based composite2,620$140$361.8K
    D0210Intraoral - complete series of radiographic images2,980$80$247.5K
    D1206Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients6,420$40$237.4K
    D1110Prophylaxis - adult; cleaning and polishing of the teeth3,710$60$222.5K
    D0150Comprehensive oral evaluation – new or established patient4,350$40$169.7K
    D0120Periodic oral evaluation - established patient4,270$40$157.8K
    D1351Sealant - per tooth2,530$50$131.6K
    D2393Resin-based composite, three surfaces, posterior660$180$118.1K
    D0274N/A5,240$20$83.9K
    D2740N/A130$640$83.7K

    Showing 1–10 of 22

    Medicaid: Competitive Analysis & Benchmarks

    How this provider's Medicaid billing volume and revenue compare to other Nebraska providers billing the same CPT/HCPCS codes.

    Full comparison — all codes billed, vs. Nebraska median

    22 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    D7210Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation; includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of…2130380$100$145.8K
    D2740N/A820110$410$104.4K
    D1351Sealant - per tooth33130460$30$84.7K
    D2392Post 2 surface resin‑based composite14140270$80$66.8K
    D1206Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients36320460$20$62.2K
    D1120Prophylaxis–child59290320$30$61K
    D7140Extraction, erupted tooth or exposed root (elevation and/or forceps removal)30100180$60$58.2K
    D0120Periodic oral evaluation - established patient42400430$20$44.3K
    D2950N/A1020190$90$35.4K
    D2391Resin‑based composite – one surface, posterior44120150$60$33.1K

    Showing 1–10 of 22

    Nearby Providers

    Other providers in the same ZIP code as Summit Dental Health - Blondo LLC, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Diabetes Supply Center Of The Midlands LLCNEDurable Medical Equipment & Medical Supplies$0$40.7M
    Inroads To Recovery, IncNEAddiction (Substance Use Disorder) Counselor$0$7.1M
    Oneworld Community Health Centers, Inc.NEFederally Qualified Health Center (FQHC)$0$3.9M
    Friendship Program IncNECommunity/Behavioral Health Agency$0$1.7M
    Makovicka Harms Group PCNEPhysical Therapist$0$1.1M
    Nebraska Smiles, LLCNEOrthodontics and Dentofacial Orthopedics Dentistry$0$677.5K
    Chi National Home Care, LLCNEHome Health Agency$0$552.5K
    Earl H. Brown IiiNEMental Health Counselor$0$531K
    West Maple Counseling AssociatesNEMental Health Counselor$0$455.8K
    Diamond Chiropractic North LLCNEChiropractor$0$392.7K

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Nebraska Providers
    0 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Nebraska Distribution
    Summit Dental Health - Blondo LLC — 5 of 22 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Nebraska