Dental
Mavi, Jasnena
Mavi, Jasnena was paid $97K by Medicaid between Jan 2019 and Aug 2019, across 13 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 46% of everything it billed.
33Billing provider infoMAVI, JASNENA
CONCORD, CA 94521
CONCORD, CA 94521
33aNPI1295249316assigned 11/28/2017
33bProvider typeDentist
28Total paid$97K
24GClaims2,025
24DCodes billed13
24AFirst – last monthJan 2019 – Aug 2019
Compared with peers
Next to other Dentist providers in California
Rank by total paid#1,374 of 2,314
Median peer was paid$185K
This provider vs. median0.5×
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 | |
|---|---|---|---|
| 2019 | 2,025 | $97K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 46% | 372 | 139 | $45K |
| D1120 | Dental cleaning, childProphylaxis - child | 12% | 291 | 291 | $12K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 10% | 358 | 358 | $10K |
| D1208 | Topical application of fluoride, excluding varnish | 8.9% | 356 | 356 | $9K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 8.2% | 53 | 29 | $8K |
| D1110 | Prophylaxis - adult | 4.5% | 86 | 86 | $4K |
| D0220 | Intraoral - periapical first radiographic image | 2.8% | 167 | 166 | $3K |
| D0210 | Intraoral - complete series of radiographic images | 2.3% | 28 | 28 | $2K |
| D0230 | Intraoral - periapical each additional radiographic image | 1.9% | 212 | 133 | $2K |
| D0274 | Bitewings - four radiographic images | 1.8% | 49 | 49 | $2K |
| D0272 | Bitewings - two radiographic images | <1% | 29 | 29 | $725.00 |
| D0140 | Limited oral evaluation - problem focused | <1% | 12 | 12 | $540.00 |
1 more codes
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 12 | $506.30 |
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.