Clinic
DR Carlos A. Heresi & Associates PLLC
DR Carlos A. Heresi & Associates PLLC was paid $354K by Medicaid between Nov 2018 and Jun 2023, across 15 billing codes. Its largest line is D1110, Prophylaxis - adult — 19% of everything it billed.
33Billing provider infoDR CARLOS A. HERESI & ASSOCIATES PLLC
FREDERICKSBURG, VA 22408
FREDERICKSBURG, VA 22408
33aNPI1619365293assigned 01/05/2015
33bProvider typeDental Clinic/Center
28Total paid$354K
24GClaims17,624
24DCodes billed15
24AFirst – last monthNov 2018 – Jun 2023
Compared with peers
Next to other Dental Clinic/Center providers in Virginia
Rank by total paid#41 of 142
Median peer was paid$75K
This provider vs. median4.8×
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 | 47 | $357.76 | |
| 2019 | 3,479 | $51K | |
| 2020 | 3,646 | $50K | |
| 2021 | 5,216 | $100K | |
| 2022 | 3,814 | $109K | |
| 2023 | 1,422 | $44K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 19% | 1,506 | 1,386 | $67K |
| D0230 | Intraoral - periapical each additional radiographic image | 12% | 5,074 | 1,763 | $41K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 11% | 422 | 219 | $38K |
| D0274 | Bitewings - four radiographic images | 10% | 1,370 | 1,283 | $36K |
| D0220 | Intraoral - periapical first radiographic image | 10% | 4,169 | 2,732 | $35K |
| D0330 | Panoramic radiographic image | 9.3% | 840 | 621 | $33K |
| D0150 | Comprehensive oral evaluation - new or established patient | 8.8% | 1,566 | 1,000 | $31K |
| D0140 | Limited oral evaluation - problem focused | 6.1% | 1,129 | 834 | $22K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 4.8% | 194 | 91 | $17K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 3.1% | 528 | 517 | $11K |
| D1208 | Topical application of fluoride, excluding varnish | 3.0% | 579 | 528 | $11K |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 2.7% | 158 | 50 | $10K |
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 officialHERESI, CARLOS (DOCTOR)