Dental
Annandale Diamond Dental
Annandale Diamond Dental was paid $97K by Medicaid between Jul 2022 and Aug 2024, across 13 billing codes. Its largest line is D1110, Prophylaxis - adult — 26% of everything it billed.
33Billing provider infoANNANDALE DIAMOND DENTAL
FALLS CHURCH, VA 22042
FALLS CHURCH, VA 22042
33aNPI1962133769assigned 06/22/2022
33bProvider typeGeneral Practice Dentistry
28Total paid$97K
24GClaims6,060
24DCodes billed13
24AFirst – last monthJul 2022 – Aug 2024
Compared with peers
Next to other General Practice Dentistry providers in Virginia
Rank by total paid#196 of 549
Median peer was paid$29K
This provider vs. median3.3×
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 | |
|---|---|---|---|
| 2022 | 1,332 | $64K | |
| 2023 | 2,713 | $33K | |
| 2024incomplete | 2,015 | $0.00 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 26% | 967 | 960 | $25K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 15% | 705 | 305 | $15K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 14% | 1,221 | 1,211 | $13K |
| D1208 | Topical application of fluoride, excluding varnish | 10% | 867 | 858 | $10K |
| D0274 | Bitewings - four radiographic images | 8.5% | 600 | 593 | $8K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 6.3% | 532 | 231 | $6K |
| D1120 | Dental cleaning, childProphylaxis - child | 6.2% | 274 | 268 | $6K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 3.7% | 73 | 41 | $4K |
| D0210 | Intraoral - complete series of radiographic images | 3.4% | 196 | 179 | $3K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.5% | 154 | 154 | $2K |
| D0140 | Limited oral evaluation - problem focused | 2.4% | 217 | 212 | $2K |
| D0330 | Panoramic radiographic image | 1.7% | 24 | 24 | $2K |
1 more codes
| D0220 | Intraoral - periapical first radiographic image | <1% | 230 | $464.96 |
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 officialSILES, KEISY (INSURANCE COORDINATOR)