Clinic
Autumn Family Dentistry, P.L.L.C.
Autumn Family Dentistry, P.L.L.C. was paid $674K by Medicaid between Dec 2020 and Dec 2024, across 17 billing codes. Its largest line is D1351, Sealant - per tooth — 20% of everything it billed.
33Billing provider infoAUTUMN FAMILY DENTISTRY, P.L.L.C.
LEAGUE CITY, TX 77573
LEAGUE CITY, TX 77573
33aNPI1568813186assigned 06/24/2016
33bProvider typeDental Clinic/Center
28Total paid$674K
24GClaims31,619
24DCodes billed17
24AFirst – last monthDec 2020 – Dec 2024
Compared with peers
Next to other Dental Clinic/Center providers in Texas
Rank by total paid#59 of 255
Median peer was paid$110K
This provider vs. median6.1×
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 | |
|---|---|---|---|
| 2020 | 33 | $176.40 | |
| 2021 | 3,928 | $61K | |
| 2022 | 7,215 | $129K | |
| 2023 | 10,389 | $228K | |
| 2024incomplete | 10,054 | $256K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1351 | Sealant - per tooth | 20% | 5,444 | 876 | $134K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 13% | 918 | 315 | $86K |
| D1120 | Dental cleaning, childProphylaxis - child | 11% | 2,254 | 2,102 | $74K |
| D0145 | Oral evaluation for a patient under three years of age | 11% | 538 | 527 | $73K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 9.0% | 2,370 | 2,222 | $61K |
| D0230 | Intraoral - periapical each additional radiographic image | 8.3% | 5,627 | 2,908 | $56K |
| D1208 | Topical application of fluoride, excluding varnish | 6.6% | 3,362 | 3,154 | $44K |
| D0220 | Intraoral - periapical first radiographic image | 5.3% | 3,232 | 2,991 | $36K |
| D1110 | Prophylaxis - adult | 4.8% | 658 | 628 | $32K |
| D0274 | Bitewings - four radiographic images | 4.3% | 1,062 | 998 | $29K |
| D0272 | Bitewings - two radiographic images | 3.9% | 1,289 | 1,222 | $26K |
| D0150 | Comprehensive oral evaluation - new or established patient | 3.0% | 640 | 593 | $20K |
5 more codes
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 officialPHAM, THIEN-KIM (DENTIST)