Dental
White, Fredric
White, Fredric was paid $735.00 by Medicaid between Jan 2018 and Dec 2018, across 18 billing codes. Its largest line is D1120, dental cleaning, child — 19% of everything it billed.
33Billing provider infoWHITE, FREDRIC
SIERRA VISTA, AZ 85635
SIERRA VISTA, AZ 85635
33aNPI1215157953assigned 04/26/2007
33bProvider typeGeneral Practice Dentistry
28Total paid$735.00
24GClaims8,118
24DCodes billed18
24AFirst – last monthJan 2018 – Dec 2018
Compared with peers
Next to other General Practice Dentistry providers in Arizona
Rank by total paid#275 of 530
Median peer was paid$920.17
This provider vs. median0.8×
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 | 8,118 | $735.00 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 19% | 1,013 | 953 | $136.00 |
| D0210 | Intraoral - complete series of radiographic images | 13% | 200 | 200 | $94.00 |
| D0150 | Comprehensive oral evaluation - new or established patient | 11% | 241 | 230 | $84.00 |
| D1208 | Topical application of fluoride, excluding varnish | 10% | 1,066 | 996 | $75.00 |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 8.7% | 415 | 264 | $64.00 |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 7.6% | 295 | 180 | $56.00 |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 6.0% | 1,149 | 1,073 | $44.00 |
| D1110 | Prophylaxis - adult | 5.7% | 386 | 359 | $42.00 |
| D1351 | Sealant - per tooth | 5.7% | 500 | 160 | $42.00 |
| D0220 | Intraoral - periapical first radiographic image | 4.1% | 553 | 506 | $30.00 |
| D0274 | Bitewings - four radiographic images | 3.0% | 419 | 391 | $22.00 |
| D0140 | Limited oral evaluation - problem focused | 3.0% | 67 | 52 | $22.00 |
6 more codes
| D0272 | Bitewings - two radiographic images | 1.9% | 584 | $14.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 1.4% | 377 | $10.00 |
| D0330 | Panoramic radiographic image | 0% | 263 | $0.00 |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 0% | 250 | $0.00 |
| D2930 | Prefabricated stainless steel crown - primary tooth | 0% | 18 | $0.00 |
| D1206 | Topical application of fluoride varnish | 0% | 322 | $0.00 |
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.