Clinic
Commonwealth Pediatric Dental Specialists
Commonwealth Pediatric Dental Specialists was paid $1.57M by Medicaid between Jan 2018 and Sep 2024, across 21 billing codes. Its largest line is D1120, dental cleaning, child — 22% of everything it billed.
33Billing provider infoCOMMONWEALTH PEDIATRIC DENTAL SPECIALISTS
SANDSTON, VA 23150
SANDSTON, VA 23150
33aNPI1679978795assigned 10/31/2014
33bProvider typeDental Clinic/Center
28Total paid$1.57M
24GClaims59,537
24DCodes billed21
24AFirst – last monthJan 2018 – Sep 2024
Compared with peers
Next to other Dental Clinic/Center providers in Virginia
Rank by total paid#18 of 142
Median peer was paid$75K
This provider vs. median21×
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 | 6,985 | $202K | |
| 2019 | 7,897 | $213K | |
| 2020 | 7,130 | $233K | |
| 2021 | 10,265 | $328K | |
| 2022 | 10,077 | $377K | |
| 2023 | 11,057 | $215K | |
| 2024incomplete | 6,126 | $0.00 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 22% | 12,742 | 12,613 | $352K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 22% | 2,681 | 629 | $350K |
| D1206 | Topical application of fluoride varnish | 16% | 14,162 | 14,021 | $244K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 13% | 12,363 | 12,233 | $201K |
| D0272 | Bitewings - two radiographic images | 6.0% | 5,515 | 5,474 | $94K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 3.7% | 1,964 | 1,905 | $57K |
| D1110 | Prophylaxis - adult | 3.5% | 1,488 | 1,483 | $55K |
| D0150 | Comprehensive oral evaluation - new or established patient | 3.4% | 1,838 | 1,829 | $53K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 3.3% | 689 | 423 | $52K |
| D0240 | 1.8% | 2,791 | 1,530 | $28K | |
| D7140 | Extraction, erupted tooth or exposed root | 1.3% | 262 | 129 | $20K |
| D1351 | Sealant - per tooth | 1.2% | 643 | 210 | $18K |
9 more codes
| D0330 | Panoramic radiographic image | <1% | 394 | $11K |
| D0220 | Intraoral - periapical first radiographic image | <1% | 1,013 | $10K |
| D0140 | Limited oral evaluation - problem focused | <1% | 249 | $6K |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 404 | $4K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 58 | $4K |
| D9630 | <1% | 130 | $3K | |
| D9310 | <1% | 31 | $3K | |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | <1% | 22 | $2K |
| D0274 | Bitewings - four radiographic images | <1% | 98 | $861.12 |
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 officialPHELPS, JOY (PEDIATRIC DENTIST/OWNER)