Dental
Old Bridge Pediatric Dentistry LLC
Old Bridge Pediatric Dentistry LLC was paid $14K by Medicaid between Oct 2024 and Dec 2024, across 14 billing codes. Its largest line is D1351, Sealant - per tooth — 28% of everything it billed.
33Billing provider infoOLD BRIDGE PEDIATRIC DENTISTRY LLC
OLD BRIDGE, NJ 08857
OLD BRIDGE, NJ 08857
33aNPI1003677477assigned 01/22/2024
33bProvider typePediatric Dentist
28Total paid$14K
24GClaims814
24DCodes billed14
24AFirst – last monthOct 2024 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in New Jersey
Rank by total paid#166 of 190
Median peer was paid$275K
This provider vs. median0.1×
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 | |
|---|---|---|---|
| 2024incomplete | 814 | $14K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1351 | Sealant - per tooth | 28% | 180 | 22 | $4K |
| D1120 | Dental cleaning, childProphylaxis - child | 25% | 118 | 116 | $4K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 10.0% | 58 | 57 | $1K |
| D0150 | Comprehensive oral evaluation - new or established patient | 8.1% | 47 | 46 | $1K |
| D1208 | Topical application of fluoride, excluding varnish | 6.9% | 80 | 80 | $987.50 |
| D0603 | 4.1% | 60 | 59 | $590.00 | |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 4.1% | 40 | 34 | $585.00 |
| D9920 | 3.1% | 26 | 26 | $448.00 | |
| D0272 | Bitewings - two radiographic images | 3.0% | 51 | 49 | $428.75 |
| D0140 | Limited oral evaluation - problem focused | 2.1% | 12 | 12 | $300.00 |
| D0220 | Intraoral - periapical first radiographic image | 1.9% | 56 | 55 | $275.00 |
| D1206 | Topical application of fluoride varnish | 1.7% | 15 | 13 | $243.75 |
2 more codes
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 officialMARTINEZ, LUIS (DIRECTOR OF REVENUE CYCLE)
| Provider | Location | Paid |
|---|---|---|
| Luis & Teresa Martinez, INC. | Laredo, TX | $162K |
| A Prestige Wellness Center, PA | Doral, FL | $55K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.