Victory Dentistry for Kids

Victory Dentistry for Kids was paid $125K by Medicaid between Jan 2018 and Dec 2019, across 12 billing codes. Its largest line is D1120, dental cleaning, child — 22% 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	3,020	$61K
2019	3,520	$65K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1120	Dental cleaning, childProphylaxis - child	22%	1,087	904	$28K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	16%	1,118	937	$21K
D1206	Topical application of fluoride varnish	14%	1,392	1,173	$18K
D1110	Prophylaxis - adult	9.6%	319	269	$12K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	8.8%	175	57	$11K
D1351	Sealant - per tooth	8.5%	579	116	$11K
D0220	Intraoral - periapical first radiographic image	5.6%	667	555	$7K
D0150	Comprehensive oral evaluation - new or established patient	4.8%	185	155	$6K
D0230	Intraoral - periapical each additional radiographic image	4.2%	624	501	$5K
D0272	Bitewings - two radiographic images	4.1%	348	299	$5K
D2391	Resin-based composite - one surface, posterior, primary or permanent	1.5%	31	14	$2K
D0274	Bitewings - four radiographic images	<1%	15	15	$406.25

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 officialMCDONALD, TASHIA (MANAGER)