Dental
One Dental Practice LLC
One Dental Practice LLC was paid $3.16M by Medicaid between Mar 2019 and Feb 2024, across 27 billing codes. Its largest line is D2740, Crown - porcelain/ceramic — 26% of everything it billed.
33Billing provider infoONE DENTAL PRACTICE LLC
CHRISTIANSTED, VI 00820
CHRISTIANSTED, VI 00820
33aNPI1114386380assigned 02/17/2016
33bProvider typeDentist
28Total paid$3.16M
24GClaims21,073
24DCodes billed27
24AFirst – last monthMar 2019 – Feb 2024
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 | |
|---|---|---|---|
| 2019 | 468 | $70K | |
| 2020 | 2,362 | $290K | |
| 2021 | 6,380 | $1.04M | |
| 2022 | 5,160 | $781K | |
| 2023 | 6,232 | $918K | |
| 2024incomplete | 471 | $60K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2740 | Crown - porcelain/ceramic | 26% | 689 | 498 | $837K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 14% | 1,860 | 1,204 | $437K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 7.9% | 1,359 | 873 | $250K |
| D4341 | 6.6% | 769 | 273 | $207K | |
| D1110 | Prophylaxis - adult | 4.7% | 1,484 | 1,465 | $148K |
| D0210 | Intraoral - complete series of radiographic images | 4.5% | 1,053 | 1,011 | $142K |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 4.3% | 452 | 218 | $136K |
| D0150 | Comprehensive oral evaluation - new or established patient | 4.1% | 1,536 | 1,485 | $128K |
| D1206 | Topical application of fluoride varnish | 3.7% | 2,728 | 2,641 | $117K |
| D4910 | 3.2% | 681 | 675 | $103K | |
| D7140 | Extraction, erupted tooth or exposed root | 3.0% | 550 | 290 | $95K |
| D0140 | Limited oral evaluation - problem focused | 2.7% | 1,153 | 1,096 | $84K |
15 more codes
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 2.2% | 259 | $71K |
| D0120 | Dental checkup, returning patient | 2.0% | 883 | $63K |
| D2950 | 1.9% | 226 | $60K | |
| D4355 | 1.8% | 317 | $57K | |
| D0274 | Bitewings - four radiographic images | 1.8% | 826 | $56K |
| D1330 | 1.5% | 1,496 | $47K | |
| D0220 | Intraoral - periapical first radiographic image | <1% | 1,007 | $28K |
| D1351 | Sealant - per tooth | <1% | 311 | $20K |
| D4921 | <1% | 315 | $19K | |
| D1120 | Dental cleaning, child | <1% | 257 | $19K |
| D9310 | <1% | 252 | $16K | |
| D0270 | <1% | 474 | $10K | |
| D4342 | <1% | 33 | $6K | |
| D0272 | Bitewings - two radiographic images | <1% | 76 | $3K |
| D9210 | <1% | 27 | $1K |
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 officialJOHNSON, AVRIL (OFFICE MANAGER)