Crowning Moment LLC

Crowning Moment LLC was paid $54K by Medicaid between Jan 2018 and Jul 2024, across 6 billing codes. Its largest line is D1110, Prophylaxis - adult — 47% of everything it billed.

33Billing provider infoCROWNING MOMENT LLC
BRAINTREE, MA 02184

33aNPI1881024545assigned 11/16/2013

33bProvider typePreferred Provider Organization

28Total paid$54K

24GClaims1,481

24DCodes billed6

24AFirst – last monthJan 2018 – Jul 2024

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	576	$21K
2019	513	$19K
2020	130	$5K
2021	83	$2K
2022	89	$3K
2023	27	$1K
2024incomplete	63	$2K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1110	Prophylaxis - adult	47%	476	469	$25K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	28%	606	602	$15K
D1208	Topical application of fluoride, excluding varnish	13%	239	239	$7K
D1120	Dental cleaning, childProphylaxis - child	7.5%	78	78	$4K
D0274	Bitewings - four radiographic images	3.8%	57	57	$2K
D1206	Topical application of fluoride varnish	1.3%	25	25	$700.00

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 officialLEE, JACK SSU-CHIEH (OWNER)