Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

DENTAL SURGERY CENTERS OF AMERICA

NPI: 1609041813 · STOCKTON, CA 95210 · Ambulatory Surgical Clinic/Center · NPI assigned 04/29/2008

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official LARSEN, DEVIN controls 20+ related entities in our dataset. Read more

$6.82M
Total Medicaid Paid
72,567
Total Claims
43,522
Beneficiaries
37
Codes Billed
2018-01
First Month
2024-10
Last Month

Provider Details

Authorized OfficialLARSEN, DEVIN (CEO)
NPI Enumeration Date04/29/2008

Related Entities

Other providers sharing the same authorized official: LARSEN, DEVIN

ProviderCityStateTotal Paid
VALLARINE DENTAL CORPORATION FRESNO CA $38.23M
COFFEE SURGERY CENTER, LLC BAKERSFIELD CA $14.86M
KC CHILDRENS SURGERY CENTER LLC KANSAS CITY KS $13.76M
HOUSTON CHILDREN'S DENTAL CENTER, LLC HOUSTON TX $11.03M
DENTAL SURGICENTER OF LOUISVILLE LLC LOUISVILLE KY $8.44M
DENTAL SURGERY CENTERS OF AMERICA ATWATER CA $7.22M
JACKSONVILLE CHILDREN'S SURGERY CENTER, LLC JACKSONVILLE FL $6.31M
MEDICAL AND DENTAL CENTER OF NEVADA LLC LAS VEGAS NV $6.00M
SAN ANTONIO CHILDRENS SURGICAL SAN ANTONIO TX $4.91M
CHILDREN 1ST HOUSTON SOUTH, LLC HOUSTON TX $3.69M
FORT MYERS CHILDREN'S SURGERY CENTER, LLC FT MYERS FL $3.42M
VISALIA CHILDREN'S DENTAL SURGERY CENTER INC VISALIA CA $3.35M
CHILDREN 1ST GRAND PRAIRIE, LLC GRAND PRAIRIE TX $3.31M
DENTAL SURGERY CENTERS OF AMERICA SANTA MARIA CA $2.66M
WEST PALM BEACH CHILDREN'S SURGERY CENTER, LLC PALM SPRINGS FL $1.63M
BLUE CLOUD ANESTHESIA, LLC TAMPA FL $1.57M
SURGICAL CENTER FOR DENTAL PROFESSIONALS OF NC LLC RALEIGH NC $1.38M
BLUE CLOUD ANESTHESIA, LLC ORLANDO FL $1.36M
DENTAL SURGICENTER OF LOUISVILLE LLC LOUISVILLE KY $965K
THE DIGESTIVE ENDOSCOPY CENTER OF MICHIGAN LLC FLINT MI $759K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 30,042 $2.52M
2019 26,413 $2.50M
2020 3,219 $376K
2021 3,895 $425K
2022 2,984 $282K
2023 3,587 $444K
2024 2,427 $267K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
00170 Anesthesia for intraoral procedures, including biopsy 5,084 5,039 $1.64M
D2930 Prefabricated stainless steel crown - primary tooth 10,587 2,153 $1.22M
D3220 Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction 8,060 2,068 $792K
D9221 2,749 2,277 $510K
D9220 2,447 2,325 $486K
D7140 Extraction, erupted tooth or exposed root 5,391 1,636 $305K
41899 Unlisted procedure, dentoalveolar structures 3,509 3,493 $274K
D2150 Silver amalgam - two surfaces, primary or permanent 2,759 1,217 $181K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 3,047 1,195 $170K
D1510 1,435 890 $169K
D9420 2,408 2,406 $168K
D2330 1,625 835 $123K
D0150 Comprehensive oral evaluation - new or established patient 2,019 2,019 $116K
99283 Emergency department visit for the evaluation and management, moderate severity 3,822 1,907 $111K
D2140 2,011 916 $108K
99201 1,701 712 $104K
D0350 2,592 2,373 $74K
0490 541 273 $56K
D0230 Intraoral - periapical each additional radiographic image 2,442 2,405 $54K
D0272 Bitewings - two radiographic images 2,401 2,400 $27K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 259 78 $19K
D1351 Sealant - per tooth 891 341 $19K
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) 3,240 3,223 $18K
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 12 12 $17K
D2331 177 120 $14K
99199 Unlisted special service, procedure or report 180 41 $9K
D1120 Prophylaxis - child 391 391 $8K
D1208 Topical application of fluoride, excluding varnish 380 380 $4K
D0145 Oral evaluation for a patient under three years of age 93 93 $4K
D2160 48 39 $4K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 78 78 $3K
0360 12 12 $1K
G0378 Hospital observation service, per hour 42 42 $998.34
J7120 Ringers lactate infusion, up to 1000 cc 98 97 $647.78
0160 12 12 $404.36
0760 12 12 $235.84
0710 12 12 $180.62