Pediatric Dental Center of Avon, LLC

Pediatric Dental Center of Avon, LLC was paid $288K by Medicaid between Jan 2018 and Apr 2024, across 7 billing codes. Its largest line is D1120, dental cleaning, child — 39% of everything it billed.

33Billing provider infoPEDIATRIC DENTAL CENTER OF AVON, LLC
AVON, CT 06001

33aNPI1033562210assigned 07/22/2016

33bProvider typePediatric Dentist

28Total paid$288K

24GClaims8,870

24DCodes billed7

24AFirst – last monthJan 2018 – Apr 2024

Compared with peers

Next to other Pediatric Dentist providers in Connecticut

Rank by total paid#44 of 84

Median peer was paid$311K

This provider vs. median0.9×

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
2018	2,036	$72K
2019	2,007	$71K
2020	1,783	$53K
2021	1,952	$57K
2022	1,048	$34K
2023	30	$825.16
2024incomplete	14	$540.96

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1120	Dental cleaning, childProphylaxis - child	39%	2,694	2,606	$111K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	28%	2,566	2,466	$80K
D1206	Topical application of fluoride varnish	23%	2,617	2,509	$67K
D0272	Bitewings - two radiographic images	8.4%	876	837	$24K
D9230	Inhalation of nitrous oxide / analgesia, anxiolysis	1.4%	72	65	$4K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	<1%	22	12	$1K
D0150	Comprehensive oral evaluation - new or established patient	<1%	23	16	$700.70

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 officialCOSGROVE, JEANMARIE (OWNER)