Dental
Eagle Crest Pediatric Dentistry
Eagle Crest Pediatric Dentistry was paid $286K by Medicaid between Apr 2018 and Dec 2024, across 19 billing codes. Its largest line is D1120, dental cleaning, child — 19% of everything it billed.
33Billing provider infoEAGLE CREST PEDIATRIC DENTISTRY
HAVERTOWN, PA 19083
HAVERTOWN, PA 19083
33aNPI1326392846assigned 11/06/2012
33bProvider typePediatric Dentist
28Total paid$286K
24GClaims13,138
24DCodes billed19
24AFirst – last monthApr 2018 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Pennsylvania
Rank by total paid#74 of 237
Median peer was paid$109K
This provider vs. median2.6×
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 | 317 | $8K | |
| 2019 | 893 | $25K | |
| 2020 | 180 | $5K | |
| 2021 | 71 | $2K | |
| 2022 | 90 | $2K | |
| 2023 | 150 | $4K | |
| 2024incomplete | 11,437 | $241K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 19% | 1,826 | 1,805 | $55K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 18% | 2,154 | 2,134 | $51K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 9.9% | 601 | 532 | $28K |
| D1208 | Topical application of fluoride, excluding varnish | 8.2% | 1,144 | 1,140 | $24K |
| D1110 | Prophylaxis - adult | 6.9% | 485 | 484 | $20K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 6.3% | 221 | 193 | $18K |
| D1206 | Topical application of fluoride varnish | 6.0% | 802 | 793 | $17K |
| D0272 | Bitewings - two radiographic images | 5.7% | 835 | 828 | $16K |
| D1330 | 3.5% | 1,532 | 1,513 | $10K | |
| D1310 | 3.4% | 1,533 | 1,514 | $10K | |
| D0274 | Bitewings - four radiographic images | 3.4% | 300 | 299 | $10K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 2.3% | 100 | 94 | $7K |
7 more codes
| D0602 | 2.3% | 655 | $6K | |
| D0603 | 1.5% | 437 | $4K | |
| D1351 | Sealant - per tooth | 1.4% | 48 | $4K |
| D0220 | Intraoral - periapical first radiographic image | 1.0% | 286 | $3K |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 16 | $2K |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 126 | $1K |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 37 | $946.38 |
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 officialWADENYA, ROSE (OWNER / PEDIATRIC DENTIST)