Mavern Suprono DDS INC

Mavern Suprono DDS INC was paid $21K by Medicaid between Jan 2018 and Jul 2020, across 9 billing codes. Its largest line is D0120, dental checkup, returning patient — 28% of everything it billed.

33Billing provider infoMAVERN SUPRONO DDS INC
COLTON, CA 92324

33aNPI1477622165assigned 11/07/2006

33bProvider typeDentist

28Total paid$21K

24GClaims897

24DCodes billed9

24AFirst – last monthJan 2018 – Jul 2020

Compared with peers

Next to other Dentist providers in California

Rank by total paid#1,760 of 2,314

Median peer was paid$185K

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
2018	379	$7K
2019	287	$7K
2020	231	$6K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	28%	140	140	$6K
D1120	Dental cleaning, childProphylaxis - child	24%	174	171	$5K
D0150	Comprehensive oral evaluation - new or established patient	18%	86	82	$4K
D0210	Intraoral - complete series of radiographic images	9.1%	39	39	$2K
D0230	Intraoral - periapical each additional radiographic image	6.4%	166	137	$1K
D1208	Topical application of fluoride, excluding varnish	5.2%	130	129	$1K
D0272	Bitewings - two radiographic images	4.5%	84	82	$922.00
D0220	Intraoral - periapical first radiographic image	3.0%	62	56	$624.00
D0350		1.5%	16	14	$297.60

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 officialSUPRONO, MAVERN (PRESIDENT)