Clinic
River City Surgical Center
River City Surgical Center was paid $4.09M by Medicaid between Jan 2018 and Dec 2024, across 28 billing codes. Its largest line is 41899, Unlisted procedure, dentoalveolar structures — 47% of everything it billed.
33Billing provider infoRIVER CITY SURGICAL CENTER
BOISE, ID 83709
BOISE, ID 83709
33aNPI1558733147assigned 10/22/2015
33bProvider typeAmbulatory Surgical Clinic/Center
28Total paid$4.09M
24GClaims21,155
24DCodes billed28
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Ambulatory Surgical Clinic/Center providers in Idaho
Rank by total paid#2 of 34
Median peer was paid$126K
This provider vs. median32×
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 | 1,230 | $714K | |
| 2019 | 1,174 | $726K | |
| 2020 | 1,807 | $628K | |
| 2021 | 3,910 | $500K | |
| 2022 | 4,114 | $514K | |
| 2023 | 4,300 | $471K | |
| 2024incomplete | 4,620 | $536K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 41899 | Unlisted procedure, dentoalveolar structures | 47% | 3,183 | 3,110 | $1.92M |
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 32% | 2,129 | 2,112 | $1.32M |
| D2930 | Prefabricated stainless steel crown - primary tooth | 5.0% | 1,182 | 1,174 | $206K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 4.0% | 1,673 | 1,667 | $165K |
| D9420 | 2.7% | 3,266 | 3,237 | $110K | |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 1.8% | 800 | 792 | $73K |
| D7140 | Extraction, erupted tooth or exposed root | 1.7% | 477 | 467 | $71K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 1.6% | 1,184 | 1,180 | $67K |
| D2934 | <1% | 79 | 79 | $37K | |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | <1% | 484 | 482 | $28K |
| D1120 | Dental cleaning, childProphylaxis - child | <1% | 1,155 | 1,145 | $18K |
| D2332 | <1% | 130 | 127 | $15K |
16 more codes
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 928 | $14K |
| D0272 | Bitewings - two radiographic images | <1% | 1,507 | $10K |
| D1206 | Topical application of fluoride varnish | <1% | 1,546 | $10K |
| D1351 | Sealant - per tooth | <1% | 224 | $7K |
| D7111 | <1% | 556 | $6K | |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 132 | $4K |
| D2330 | <1% | 76 | $4K | |
| D2335 | <1% | 16 | $3K | |
| D0220 | Intraoral - periapical first radiographic image | <1% | 137 | $1K |
| D1110 | Prophylaxis - adult | <1% | 13 | $511.55 |
| D1510 | 0% | 13 | $0.00 | |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 0% | 12 | $0.00 |
| D0274 | Bitewings - four radiographic images | 0% | 26 | $0.00 |
| G0330 | Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operating room | 0% | 21 | $0.00 |
| D7240 | Removal of impacted tooth - completely bony | 0% | 189 | $0.00 |
| D7230 | 0% | 17 | $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.
From NPPES
Who's on the registration
Authorized officialROGERS, ROY (MEMBER)
| Provider | Location | Paid |
|---|---|---|
| Treasure Valley Pediatric Dentistry | Boise, ID | $3.19M |
| R & D Anesthesia | Boise, ID | $938K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.