Dental
Charlottesville Pediatric Dentistry LLC
Charlottesville Pediatric Dentistry LLC was paid $54K by Medicaid between Aug 2022 and Sep 2024, across 8 billing codes. Its largest line is D1120, dental cleaning, child — 37% of everything it billed.
33Billing provider infoCHARLOTTESVILLE PEDIATRIC DENTISTRY LLC
CHARLOTTESVILLE, VA 22911
CHARLOTTESVILLE, VA 22911
33aNPI1023740180assigned 06/28/2022
33bProvider typePediatric Dentist
28Total paid$54K
24GClaims3,957
24DCodes billed8
24AFirst – last monthAug 2022 – Sep 2024
Compared with peers
Next to other Pediatric Dentist providers in Virginia
Rank by total paid#99 of 140
Median peer was paid$234K
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 | 824 | $22K | |
| 2023 | 2,040 | $32K | |
| 2024incomplete | 1,093 | $0.00 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 37% | 997 | 990 | $20K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 31% | 1,454 | 1,442 | $17K |
| D1208 | Topical application of fluoride, excluding varnish | 15% | 348 | 348 | $8K |
| D1206 | Topical application of fluoride varnish | 12% | 962 | 951 | $7K |
| D1110 | Prophylaxis - adult | 3.2% | 83 | 80 | $2K |
| D0272 | Bitewings - two radiographic images | 1.6% | 73 | 73 | $851.45 |
| D0274 | Bitewings - four radiographic images | <1% | 13 | 13 | $466.44 |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 0% | 27 | 14 | $0.00 |
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 officialHEATH, BROOKE (OFFICE MANAGER)