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PEDIATRIC DENTAL CENTER OF AVON, LLC
PEDIATRIC DENTAL CENTER OF AVON, LLC
NPI: 1033562210
· AVON, CT 06001
· Pediatric Dentist
· NPI assigned 07/22/2016
$288K
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total 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 |
| 2024 |
14 |
$540.96 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
2,694 |
2,606 |
$111K |
| D0120 |
Periodic oral evaluation - established patient |
2,566 |
2,466 |
$80K |
| D1206 |
Topical application of fluoride varnish |
2,617 |
2,509 |
$67K |
| D0272 |
Bitewings - two radiographic images |
876 |
837 |
$24K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
72 |
65 |
$4K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
22 |
12 |
$1K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
23 |
16 |
$700.70 |