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    OpenPayerNPI Medicare & MedicaidSiouxland Dental Health - South Sioux, LLC
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    Siouxland Dental Health - South Sioux, LLC — Billing Profile & Reimbursement Data

    NPI 1386981561 · South Sioux City, NE · General Practice Dentistry

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    Siouxland Dental Health - South Sioux, LLC is a general practice dentistry provider located in South Sioux City, Nebraska. This profile covers 0 Medicare and 23 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
    OrganizationSiouxland Dental Health - South Sioux, LLC
    Address2600 Cornhusker Dr
    CitySouth Sioux City
    StateNE
    ZIP68776
    TaxonomyGeneral Practice Dentistry
    NPI EnumeratedJanuary 9, 2013

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

    Payer SourceTotal Paid
    Medicaid$1.8M
    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.

    23 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    D2392Post 2 surface resin‑based composite3,050$90$284K
    D1206Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients10,990$20$263.7K
    D0120Periodic oral evaluation - established patient9,720$30$262.5K
    D1110Prophylaxis - adult; cleaning and polishing of the teeth4,360$50$196.1K
    D1120Prophylaxis–child5,670$30$192.6K
    D1351Sealant - per tooth5,090$30$157.9K
    D0274N/A3,630$30$101.6K
    D2391Resin‑based composite – one surface, posterior920$70$60.4K
    D0150Comprehensive oral evaluation – new or established patient1,240$30$39.6K
    D7140Extraction, erupted tooth or exposed root (elevation and/or forceps removal)770$50$37.7K

    Showing 1–10 of 23

    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

    23 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…2730380$100$145.8K
    D2740N/A1320110$410$104.4K
    D1351Sealant - per tooth18130460$30$84.7K
    D2392Post 2 surface resin‑based composite10140270$80$66.8K
    D1206Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients15320460$20$62.2K
    D1120Prophylaxis–child30290320$30$61K
    D7140Extraction, erupted tooth or exposed root (elevation and/or forceps removal)24100180$60$58.2K
    D0120Periodic oral evaluation - established patient15400430$20$44.3K
    D2391Resin‑based composite – one surface, posterior22120150$60$33.1K
    D9230N/A4090260$30$32.2K

    Showing 1–10 of 23

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Siouxland Dental Health - South Sioux, LLC, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Siouxland Dental HealthIADentist$0$1.8M

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Heartland Counseling Services, Inc.NECommunity/Behavioral Health Agency$0$2.3M
    Riverview Surgical Center LLCNEAmbulatory Surgical Clinic/Center$1.7M$0
    Tri-state Physicians & Physical Therapy Clinic PCNEChiropractor$0$1.4M
    Mercy Medical ServicesNEFamily Medicine Physician$0$1.1M
    Drs. Kincaid And FettNEEyewear Supplier$0$683.8K
    Community Rehab LLCNEPhysical Therapist$0$524.7K
    Spenser MortonNEOphthalmology Physician$375.7K$0
    Thomas WenteNEFamily Medicine Physician$140.2K$0
    Michael HattanNEFamily Medicine Physician$115.9K$0
    David EnszNEFamily Medicine Physician$115.9K$0

    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
    Siouxland Dental Health - South Sioux, LLC — 3 of 23 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Nebraska