Dental
Montefiore Dental Department
Montefiore Dental Department was paid $352K by Medicaid between Jan 2018 and Dec 2024, across 20 billing codes. Its largest line is D0120, dental checkup, returning patient — 27% of everything it billed.
33Billing provider infoMONTEFIORE DENTAL DEPARTMENT
BRONX, NY 10451
BRONX, NY 10451
33aNPI1164627469assigned 06/18/2007
33bProvider typeDentist
28Total paid$352K
24GClaims20,503
24DCodes billed20
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Dentist providers in New York
Rank by total paid#290 of 1,649
Median peer was paid$49K
This provider vs. median7.1×
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 | |
|---|---|---|---|
| 2018 | 5,601 | $94K | |
| 2019 | 6,949 | $120K | |
| 2020 | 2,787 | $45K | |
| 2021 | 1,508 | $25K | |
| 2023 | 1,350 | $22K | |
| 2024incomplete | 2,308 | $47K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 27% | 4,234 | 4,232 | $95K |
| D1110 | Prophylaxis - adult | 20% | 1,799 | 1,798 | $70K |
| D0274 | Bitewings - four radiographic images | 16% | 2,549 | 2,548 | $55K |
| D0220 | Intraoral - periapical first radiographic image | 10% | 4,362 | 4,340 | $36K |
| D0230 | Intraoral - periapical each additional radiographic image | 8.8% | 3,712 | 3,709 | $31K |
| D1120 | Dental cleaning, childProphylaxis - child | 6.1% | 574 | 574 | $22K |
| D1208 | Topical application of fluoride, excluding varnish | 2.8% | 738 | 738 | $10K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 2.2% | 147 | 130 | $8K |
| D0210 | Intraoral - complete series of radiographic images | 1.9% | 767 | 767 | $7K |
| D9110 | 1.6% | 320 | 317 | $6K | |
| D0272 | Bitewings - two radiographic images | 1.5% | 422 | 422 | $5K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 1.5% | 79 | 74 | $5K |
8 more codes
| D0330 | Panoramic radiographic image | <1% | 70 | $2K |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 30 | $840.00 |
| D1206 | Topical application of fluoride varnish | <1% | 17 | $510.00 |
| D0140 | Limited oral evaluation - problem focused | <1% | 13 | $182.00 |
| D0270 | <1% | 17 | $127.52 | |
| D0180 | 0% | 29 | $0.00 | |
| D1330 | 0% | 584 | $0.00 | |
| D9999 | Unspecified adjunctive procedure, by report | 0% | 40 | $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 officialBROCKETT, CHARLES (ADMINISTRATOR)
| Provider | Location | Paid |
|---|---|---|
| Montefiore Dental | Bronx, NY | $3.17M |
| Montefiore Dental Department | Bronx, NY | $2.91M |
| Montefiore Dental | Bronx, NY | $2.26M |
| Montefiore Dental Department | Bronx, NY | $1.78M |
| Montefiore Dental Department | Bronx, NY | $1.63M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.