Clinic
Lortontown Dental
Lortontown Dental was paid $25K by Medicaid between Sep 2020 and Aug 2024, across 11 billing codes. Its largest line is D2393, Resin-based composite - three surfaces, posterior, primary or permanent — 19% of everything it billed.
33Billing provider infoLORTONTOWN DENTAL
LORTON, VA 22079
LORTON, VA 22079
33aNPI1669097044assigned 06/11/2020
33bProvider typeDental Clinic/Center
28Total paid$25K
24GClaims1,811
24DCodes billed11
24AFirst – last monthSep 2020 – Aug 2024
Compared with peers
Next to other Dental Clinic/Center providers in Virginia
Rank by total paid#89 of 142
Median peer was paid$75K
This provider vs. median0.3×
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 | 164 | $2K | |
| 2021 | 214 | $3K | |
| 2022 | 60 | $2K | |
| 2023 | 877 | $18K | |
| 2024incomplete | 496 | $0.00 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 19% | 40 | 12 | $5K |
| D0150 | Comprehensive oral evaluation - new or established patient | 18% | 184 | 177 | $5K |
| D0274 | Bitewings - four radiographic images | 16% | 239 | 239 | $4K |
| D0220 | Intraoral - periapical first radiographic image | 16% | 512 | 492 | $4K |
| D0230 | Intraoral - periapical each additional radiographic image | 15% | 494 | 312 | $4K |
| D1110 | Prophylaxis - adult | 9.6% | 183 | 183 | $2K |
| D0330 | Panoramic radiographic image | 4.5% | 18 | 17 | $1K |
| D0140 | Limited oral evaluation - problem focused | 1.1% | 12 | 12 | $273.13 |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | <1% | 69 | 69 | $241.80 |
| D2740 | Crown - porcelain/ceramic | 0% | 16 | 13 | $0.00 |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 0% | 44 | 26 | $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 officialKHATTAB, SAMER (CEO)
| Provider | Location | Paid |
|---|---|---|
| Khattab Uthman Dental Associates | Woodbridge, VA | $276K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.