Clinic
City Dental LLC
City Dental LLC was paid $5K by Medicaid between Aug 2024 and Dec 2024, across 5 billing codes. Its largest line is D1110, Prophylaxis - adult — 36% of everything it billed.
33Billing provider infoCITY DENTAL LLC
PHILADELPHIA, PA 19147
PHILADELPHIA, PA 19147
33aNPI1972072908assigned 11/20/2018
33bProvider typeDental Clinic/Center
28Total paid$5K
24GClaims292
24DCodes billed5
24AFirst – last monthAug 2024 – Dec 2024
Compared with peers
Next to other Dental Clinic/Center providers in Pennsylvania
Rank by total paid#65 of 78
Median peer was paid$70K
This provider vs. median0.1×
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 | |
|---|---|---|---|
| 2024incomplete | 292 | $5K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 36% | 59 | 58 | $2K |
| D0274 | Bitewings - four radiographic images | 34% | 67 | 66 | $2K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 11% | 30 | 30 | $567.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 9.6% | 68 | 67 | $498.96 |
| D0220 | Intraoral - periapical first radiographic image | 9.6% | 68 | 67 | $498.96 |
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 officialCHAE, JAE (OWNER)