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D4921
Billing code D4921
HHS publishes no description for this code; it is likely a state-specific local code.
Medicaid paid $122K on code D4921 from 2018 through 2024, to 138 providers — the #5,903 code in the file by dollars. 69% of it was billed in Virgin Islands.
28Total paid$122K
24GClaims77,632
Paid per claim line$1.57
33Providers billing it138
Box 32 · Location
Where D4921 is billed
The largest of 19 states and territories, by the billing provider's address. States cover different services and set their own rates, so the same code can mean different things in different programs.
Ranked
Top providers billing D4921
| # | Provider | Location | Claims | Paid on D4921 |
|---|---|---|---|---|
| 1 | Jones, Duanne | St Thomas, VI | 452 | $65K |
| 2 | One Dental Practice LLC | Christiansted, VI | 315 | $19K |
| 3 | Rouhani and Khabbaz Dental Corporation | Pasadena, CA | 91 | $17K |
| 4 | Heather M. Wilmore, DDS, PLLC | Houston, TX | 109 | $14K |
| 5 | Arguello, Vigarny | Margate, FL | 16 | $2K |
| 6 | A. Nguyen Dental Corporation | Santa Ana, CA | 94 | $1K |
| 7 | Family Dental Associates PA | Margate, FL | 50 | $1K |
| 8 | Tavallaei, D.M.D., Corporation | Folsom, CA | 530 | $760.00 |
| 9 | Dental Center at Forest Hill, PA | West Palm Beach, FL | 334 | $464.65 |
| 10 | Mandefro, Azaryas | Arnold, MO | 54 | $402.10 |
| 11 | Tavallaei, D.M.D., Corporation | Elk Grove, CA | 158 | $320.00 |
| 12 | Snider-Gomez, Erica | Belle Glade, FL | 199 | $187.26 |
| 13 | The Institute for Family Health | New York, NY | 175 | $114.24 |
| 14 | Michael D. Quasha Dmd,pa | Palm Beach Gardens, FL | 3,774 | $98.39 |
| 15 | Obt Dental Spa | Orlando, FL | 23 | $92.13 |
| 16 | Quasha, Michael | Palm Beach Gardens, FL | 5,891 | $91.66 |
| 17 | Tavallaei, D.M.D., Corporation | Citrus Heights, CA | 71 | $60.00 |
| 18 | Gentle Dental Shores PLLC | Saint Clair Shores, MI | 583 | $21.60 |
| 19 | Western Dental Services, INC. | Sacramento, CA | 384 | $0.00 |
| 20 | Miller Dental Practice PLLC | Grandville, MI | 3,807 | $0.00 |
| 21 | Central Maine Dental, L.L.C. | Lewiston, ME | 722 | $0.00 |
| 22 | Willamette Dental Group, P.C. | Hillsboro, OR | 476 | $0.00 |
| 23 | Fernandez Dominguez, Giselle | Gainesville, FL | 212 | $0.00 |
| 24 | Western Dental Services, INC. | Salinas, CA | 205 | $0.00 |
| 25 | Western Dental Services, INC. | Sacramento, CA | 1,836 | $0.00 |
| 26 | Ideal Dental of Murfreesboro PLLC | Murfreesboro, TN | 213 | $0.00 |
| 27 | Western Dental Services, INC. | Sacramento, CA | 58 | $0.00 |
| 28 | White, Nicholas | Kansas City, MO | 236 | $0.00 |
| 29 | Western Dental Services, INC. | Sacramento, CA | 2,244 | $0.00 |
| 30 | Western Dental Services, INC. | Dinuba, CA | 154 | $0.00 |
| 31 | Coast Florida P.A. | Tampa, FL | 916 | $0.00 |
| 32 | S. Jang DDS Incorporated | Folsom, CA | 23 | $0.00 |
| 33 | Cherag Dinshaw Sarkari DDS a Dental Corporation | Panorama City, CA | 1,523 | $0.00 |
| 34 | Western Dental Services, INC. | Orange, CA | 1,297 | $0.00 |
| 35 | Smith, Damone | Sunrise, FL | 485 | $0.00 |
| 36 | Pham, Tan | Vancouver, WA | 349 | $0.00 |
| 37 | Western Dental Services, INC. | San Diego, CA | 47 | $0.00 |
| 38 | Del Togno Armanasco, Richard | Portland, OR | 57 | $0.00 |
| 39 | Western Dental Services, INC. | Los Angeles, CA | 801 | $0.00 |
| 40 | Western Dental Services, INC. | Sacramento, CA | 663 | $0.00 |
| 41 | Alles & Associates North Carolina | Fayetteville, NC | 467 | $0.00 |
| 42 | Western Dental Services, INC. | National City, CA | 240 | $0.00 |
| 43 | Professional Dental Alliance of Indiana, LLC | New Castle, PA | 461 | $0.00 |
| 44 | Bogdan, Beniamin | Sherwood, OR | 480 | $0.00 |
| 45 | Western Dental Services, INC. | Los Angeles, CA | 80 | $0.00 |
| 46 | Western Dental Services, INC. | Los Angeles, CA | 282 | $0.00 |
| 47 | Western Dental Services, INC. | Panorama City, CA | 807 | $0.00 |
| 48 | Bunn, Steven | Glen Allen, VA | 56 | $0.00 |
| 49 | Arrow Dental LLC | Scappoose, OR | 40 | $0.00 |
| 50 | Wilmington Community Clinic | Wilmington, CA | 18 | $0.00 |
| 51 | Western Dental Services, INC. | Sacramento, CA | 1,285 | $0.00 |
| 52 | WH FL Dental PLLC | Brandon, FL | 73 | $0.00 |
| 53 | Western Dental Services, INC. | Los Angeles, CA | 222 | $0.00 |
| 54 | Cherag Dinshaw Sarkari DDS a Dental Corporation | Palmdale, CA | 83 | $0.00 |
| 55 | Western Dental Services, INC. | Victorville, CA | 516 | $0.00 |
| 56 | Ideal Dental Gallatin PLLC | Gallatin, TN | 142 | $0.00 |
| 57 | Western Dental Services, INC. | Sacramento, CA | 642 | $0.00 |
| 58 | Jainandan, Kenneth | Tampa, FL | 873 | $0.00 |
| 59 | Erwin, Stephen | Portland, OR | 58 | $0.00 |
| 60 | Ospina, Carolina | St Petersburg, FL | 115 | $0.00 |
| 61 | Western Dental Services, INC. | Los Angeles, CA | 1,190 | $0.00 |
| 62 | Tri-County Community Dental Clinic, INC. | Appleton, WI | 123 | $0.00 |
| 63 | Martin, Michele | Los Angeles, CA | 71 | $0.00 |
| 64 | Cullen, William | Ponte Vedra, FL | 21 | $0.00 |
| 65 | Cherag Dinshaw Sarkari DDS a Dental Corporation | Sacramento, CA | 50 | $0.00 |
| 66 | Bravo Dental P.A. | North Miami Beach, FL | 46 | $0.00 |
| 67 | Savina, Julia | Lake Oswego, OR | 182 | $0.00 |
| 68 | Western Dental Services, INC. | Canoga Park, CA | 74 | $0.00 |
| 69 | WH FL Dental PLLC | New Port Richey, FL | 41 | $0.00 |
| 70 | Western Dental Services, INC. | Long Beach, CA | 178 | $0.00 |
| 71 | Dental Associates of Florida (S. Lakeland) PLLC | Lakeland, FL | 36 | $0.00 |
| 72 | Western Dental Services, INC. | Covina, CA | 49 | $0.00 |
| 73 | County of Tillamook | Tillamook, OR | 42 | $0.00 |
| 74 | Tawfiq Alkilani DDS PLLC | Traverse City, MI | 54 | $0.00 |
| 75 | Ostovar, Merat | Hillsboro, OR | 44 | $0.00 |
| 76 | Western Dental Services, INC. | Salinas, CA | 53 | $0.00 |
| 77 | Countryside Mall Dental PA | Clearwater, FL | 64 | $0.00 |
| 78 | Western Dental Services, INC. | Folsom, CA | 54 | $0.00 |
| 79 | Carlesimo, Peter | Salem, OR | 33 | $0.00 |
| 80 | Western Dental Services, INC. | Visalia, CA | 57 | $0.00 |
| 81 | Izraylev, Mikhail | Woodburn, OR | 86 | $0.00 |
| 82 | County of San Bernardino | San Bernardino, CA | 54 | $0.00 |
| 83 | Western Dental Services, INC. | Sacramento, CA | 41 | $0.00 |
| 84 | Western Dental Services, INC. | El Centro, CA | 100 | $0.00 |
| 85 | Yan Kalika Dental Corporation | West Sacramento, CA | 44 | $0.00 |
| 86 | Gentle Dental Westland PLLC | Westland, MI | 25 | $0.00 |
| 87 | Mobilecare Dental, PLLC | Van Buren, AR | 17,609 | $0.00 |
| 88 | Western Dental Services, INC. | Lynwood, CA | 65 | $0.00 |
| 89 | Western Dental Services, INC. | Lomita, CA | 281 | $0.00 |
| 90 | Capitol Dental Group, PC | Vancouver, WA | 3,170 | $0.00 |
| 91 | Dental Associates of Florida (Tampa) PLLC | Tampa, FL | 324 | $0.00 |
| 92 | Aspen Dental of Michigan PC | Grandville, MI | 308 | $0.00 |
| 93 | Western Dental Services, INC. | Los Angeles, CA | 1,950 | $0.00 |
| 94 | WH FL Dental PLLC | Sanford, FL | 37 | $0.00 |
| 95 | Western Dental Services, INC | Gilroy, CA | 471 | $0.00 |
| 96 | Western Dental Services, INC. | Lancaster, CA | 87 | $0.00 |
| 97 | Crawshaw, Kyle | Solon, OH | 146 | $0.00 |
| 98 | WH FL Dental PLLC | Orlando, FL | 100 | $0.00 |
| 99 | Ansari, Parisa | Eugene, OR | 1,061 | $0.00 |
| 100 | Western Dental Services, INC. | El Monte, CA | 2,235 | $0.00 |