Dental
Fredonia Pediatric and Adolescent Dentistry PLLC
Fredonia Pediatric and Adolescent Dentistry PLLC was paid $3.84M by Medicaid between Jan 2018 and Nov 2024, across 27 billing codes. Its largest line is D1120, dental cleaning, child — 20% of everything it billed.
33Billing provider infoFREDONIA PEDIATRIC AND ADOLESCENT DENTISTRY PLLC
FREDONIA, NY 14063
FREDONIA, NY 14063
33aNPI1558811646assigned 10/12/2016
33bProvider typePediatric Dentist
28Total paid$3.84M
24GClaims96,447
24DCodes billed27
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Pediatric Dentist providers in New York
Rank by total paid#32 of 514
Median peer was paid$196K
This provider vs. median20×
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 | 8,638 | $396K | |
| 2019 | 12,428 | $550K | |
| 2020 | 15,217 | $529K | |
| 2021 | 20,085 | $811K | |
| 2022 | 21,112 | $840K | |
| 2023 | 15,982 | $629K | |
| 2024incomplete | 2,985 | $90K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 20% | 17,873 | 17,872 | $761K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 13% | 18,569 | 18,567 | $500K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 10% | 3,896 | 3,439 | $388K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 9.6% | 1,610 | 947 | $369K |
| D1206 | Topical application of fluoride varnish | 7.8% | 10,376 | 10,372 | $298K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 6.2% | 3,679 | 3,251 | $239K |
| D1351 | Sealant - per tooth | 6.1% | 3,099 | 2,384 | $234K |
| D7140 | Extraction, erupted tooth or exposed root | 4.4% | 2,392 | 1,892 | $167K |
| D1110 | Prophylaxis - adult | 4.2% | 3,063 | 3,063 | $162K |
| D1208 | Topical application of fluoride, excluding varnish | 4.1% | 11,211 | 11,210 | $156K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 3.2% | 936 | 651 | $124K |
| D0272 | Bitewings - two radiographic images | 2.8% | 6,721 | 6,721 | $106K |
15 more codes
| D0330 | Panoramic radiographic image | 2.5% | 2,630 | $95K |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.8% | 2,337 | $69K |
| D0274 | Bitewings - four radiographic images | 1.3% | 1,947 | $52K |
| D9420 | <1% | 463 | $38K | |
| D0220 | Intraoral - periapical first radiographic image | <1% | 2,316 | $29K |
| D9110 | <1% | 604 | $15K | |
| D1354 | <1% | 455 | $9K | |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | <1% | 399 | $9K |
| D9310 | <1% | 97 | $8K | |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 75 | $8K |
| D0140 | Limited oral evaluation - problem focused | <1% | 360 | $5K |
| D9430 | <1% | 206 | $3K | |
| D2330 | <1% | 16 | $1K | |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 26 | $210.82 |
| D1999 | 0% | 1,091 | $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 officialLUKASIK, ANTOINETTE (PEDIATRIC DENTIST)