Clinic
Edegar Vergara, DMD INC
Edegar Vergara, DMD INC was paid $792K by Medicaid between Jan 2019 and Dec 2024, across 21 billing codes. Its largest line is D1110, Prophylaxis - adult — 20% of everything it billed.
33Billing provider infoEDEGAR VERGARA, DMD INC
SAN JOSE, CA 95116
SAN JOSE, CA 95116
33aNPI1699262634assigned 04/16/2018
33bProvider typeDental Clinic/Center
28Total paid$792K
24GClaims23,418
24DCodes billed21
24AFirst – last monthJan 2019 – Dec 2024
Compared with peers
Next to other Dental Clinic/Center providers in California
Rank by total paid#281 of 1,135
Median peer was paid$200K
This provider vs. median4.0×
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 | 993 | $29K | |
| 2020 | 2,065 | $60K | |
| 2021 | 3,785 | $115K | |
| 2022 | 4,136 | $123K | |
| 2023 | 5,131 | $152K | |
| 2024incomplete | 7,308 | $315K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 20% | 1,814 | 1,810 | $161K |
| D0150 | Comprehensive oral evaluation - new or established patient | 16% | 1,912 | 1,910 | $126K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 9.4% | 1,015 | 1,010 | $74K |
| D2740 | Crown - porcelain/ceramic | 8.7% | 135 | 114 | $69K |
| D0210 | Intraoral - complete series of radiographic images | 8.5% | 1,399 | 1,396 | $68K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 6.7% | 959 | 461 | $53K |
| D0350 | 6.5% | 5,356 | 1,455 | $51K | |
| D9430 | 5.1% | 1,254 | 1,237 | $40K | |
| D1208 | Topical application of fluoride, excluding varnish | 4.9% | 2,757 | 2,749 | $39K |
| D1120 | Dental cleaning, childProphylaxis - child | 4.4% | 796 | 793 | $35K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 2.3% | 269 | 220 | $18K |
| D0220 | Intraoral - periapical first radiographic image | 2.1% | 1,371 | 1,354 | $16K |
9 more codes
| D0230 | Intraoral - periapical each additional radiographic image | 1.8% | 3,600 | $15K |
| D0274 | Bitewings - four radiographic images | 1.4% | 500 | $11K |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | <1% | 71 | $8K |
| D4910 | <1% | 37 | $3K | |
| D0330 | Panoramic radiographic image | <1% | 70 | $2K |
| D1351 | Sealant - per tooth | <1% | 54 | $2K |
| D1320 | <1% | 25 | $347.50 | |
| D1206 | Topical application of fluoride varnish | <1% | 12 | $267.50 |
| D0272 | Bitewings - two radiographic images | <1% | 12 | $130.00 |
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 officialVERGARA, EDEGAR (CEO)