Dental
Premium Family Dentistry
Premium Family Dentistry was paid $12K by Medicaid between May 2023 and Oct 2024, across 5 billing codes. Its largest line is D1110, Prophylaxis - adult — 54% of everything it billed.
33Billing provider infoPREMIUM FAMILY DENTISTRY
GREENBELT, MD 20770
GREENBELT, MD 20770
33aNPI1316640030assigned 03/22/2023
33bProvider typeGeneral Practice Dentistry
28Total paid$12K
24GClaims346
24DCodes billed5
24AFirst – last monthMay 2023 – Oct 2024
Compared with peers
Next to other General Practice Dentistry providers in Maryland
Rank by total paid#409 of 598
Median peer was paid$42K
This provider vs. median0.3×
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 | |
|---|---|---|---|
| 2023 | 146 | $5K | |
| 2024incomplete | 200 | $7K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 54% | 100 | 100 | $7K |
| D1206 | Topical application of fluoride varnish | 35% | 167 | 167 | $4K |
| D0210 | Intraoral - complete series of radiographic images | 5.5% | 12 | 12 | $684.00 |
| D0220 | Intraoral - periapical first radiographic image | 5.2% | 55 | 55 | $650.10 |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 12 | 12 | $78.72 |
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 officialJORDAN, NARGIS (OWNER/DENTIST)