Avon Village Family Dentistry

Avon Village Family Dentistry was paid $45K by Medicaid between Feb 2018 and Dec 2024, across 4 billing codes. Its largest line is D0120, dental checkup, returning patient — 51% of everything it billed.

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	99	$2K
2019	131	$3K
2020	88	$2K
2021	315	$6K
2022	335	$8K
2023	477	$12K
2024incomplete	549	$12K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	51%	1,142	1,080	$23K
D1110	Prophylaxis - adult	40%	733	680	$18K
D1120	Dental cleaning, childProphylaxis - child	6.5%	78	75	$3K
D1206	Topical application of fluoride varnish	2.1%	41	37	$919.22

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 officialMENTASTI, LAUREN (OWNER)