Dental
Valderrama, Edgar
Valderrama, Edgar was paid $161.16 by Medicaid between Jun 2018 and Apr 2023, across 9 billing codes. Its largest line is D0210, Intraoral - complete series of radiographic images — 100% of everything it billed.
33Billing provider infoVALDERRAMA, EDGAR
TUCSON, AZ 85741
TUCSON, AZ 85741
33aNPI1487769329assigned 08/20/2006
33bProvider typeGeneral Practice Dentistry
28Total paid$161.16
24GClaims712
24DCodes billed9
24AFirst – last monthJun 2018 – Apr 2023
Compared with peers
Next to other General Practice Dentistry providers in Arizona
Rank by total paid#330 of 530
Median peer was paid$920.17
This provider vs. median0.2×
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 | 165 | $0.00 | |
| 2020 | 15 | $0.00 | |
| 2021 | 173 | $161.16 | |
| 2022 | 286 | $0.00 | |
| 2023 | 73 | $0.00 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0210 | Intraoral - complete series of radiographic images | 100% | 165 | 158 | $161.16 |
| D1206 | Topical application of fluoride varnish | 0% | 107 | 102 | $0.00 |
| D0150 | Comprehensive oral evaluation - new or established patient | 0% | 117 | 111 | $0.00 |
| D1330 | 0% | 39 | 39 | $0.00 | |
| D0220 | Intraoral - periapical first radiographic image | 0% | 15 | 12 | $0.00 |
| D0274 | Bitewings - four radiographic images | 0% | 31 | 30 | $0.00 |
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 0% | 75 | 59 | $0.00 |
| D1120 | Dental cleaning, childProphylaxis - child | 0% | 13 | 13 | $0.00 |
| D4381 | 0% | 150 | 13 | $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.