Dental
Montefiore Dental Department
Montefiore Dental Department was paid $1.78M by Medicaid between Jan 2018 and Dec 2024, across 35 billing codes. Its largest line is D1120, dental cleaning, child — 15% of everything it billed.
33Billing provider infoMONTEFIORE DENTAL DEPARTMENT
BRONX, NY 10459
BRONX, NY 10459
33aNPI1598960817assigned 06/18/2007
33bProvider typeDentist
28Total paid$1.78M
24GClaims90,468
24DCodes billed35
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Dentist providers in New York
Rank by total paid#51 of 1,649
Median peer was paid$49K
This provider vs. median36×
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 | 25,176 | $486K | |
| 2019 | 26,206 | $465K | |
| 2020 | 12,783 | $220K | |
| 2021 | 5,579 | $102K | |
| 2023 | 9,052 | $227K | |
| 2024incomplete | 11,672 | $279K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 15% | 7,523 | 7,523 | $269K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 15% | 11,703 | 11,699 | $260K |
| D1110 | Prophylaxis - adult | 7.9% | 3,520 | 3,518 | $140K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 7.5% | 2,217 | 2,060 | $134K |
| D0274 | Bitewings - four radiographic images | 6.5% | 5,558 | 5,556 | $116K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 6.0% | 2,396 | 2,207 | $106K |
| D1351 | Sealant - per tooth | 5.8% | 1,694 | 1,257 | $103K |
| D0220 | Intraoral - periapical first radiographic image | 4.4% | 9,399 | 9,322 | $79K |
| D1208 | Topical application of fluoride, excluding varnish | 3.9% | 5,669 | 5,666 | $69K |
| D7140 | Extraction, erupted tooth or exposed root | 3.7% | 1,409 | 1,292 | $67K |
| D0272 | Bitewings - two radiographic images | 3.7% | 5,222 | 5,221 | $66K |
| D1206 | Topical application of fluoride varnish | 3.5% | 2,081 | 2,081 | $62K |
23 more codes
| D0230 | Intraoral - periapical each additional radiographic image | 3.3% | 6,353 | $59K |
| D0330 | Panoramic radiographic image | 2.5% | 1,471 | $44K |
| D1354 | 2.3% | 2,978 | $41K | |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.3% | 1,687 | $41K |
| D0140 | Limited oral evaluation - problem focused | 2.2% | 3,535 | $38K |
| D0210 | Intraoral - complete series of radiographic images | 1.7% | 2,874 | $30K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 1.1% | 193 | $20K |
| D0270 | <1% | 1,486 | $11K | |
| D0240 | <1% | 577 | $6K | |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | <1% | 1,796 | $5K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 58 | $4K |
| D9110 | <1% | 204 | $4K | |
| D2331 | <1% | 25 | $2K | |
| D2330 | <1% | 32 | $2K | |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 31 | $867.00 |
| D9920 | <1% | 16 | $220.36 | |
| D0180 | 0% | 26 | $0.00 | |
| D1330 | 0% | 5,119 | $0.00 | |
| D9215 | 0% | 1,237 | $0.00 | |
| D9999 | Unspecified adjunctive procedure, by report | 0% | 1,274 | $0.00 |
| D9630 | 0% | 993 | $0.00 | |
| D6999 | 0% | 41 | $0.00 | |
| D5899 | 0% | 71 | $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 officialBROCKETT, CHARLES (ADMINISTRATOR)
| Provider | Location | Paid |
|---|---|---|
| Montefiore Dental | Bronx, NY | $3.17M |
| Montefiore Dental Department | Bronx, NY | $2.91M |
| Montefiore Dental | Bronx, NY | $2.26M |
| Montefiore Dental Department | Bronx, NY | $1.63M |
| Montefiore Dental Department | Bronx, NY | $352K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.