Mondragon, Robert

Mondragon, Robert was paid $2K by Medicaid between Aug 2018 and Nov 2018, across 3 billing codes. Its largest line is D1120, dental cleaning, child — 51% of everything it billed.

33Billing provider infoMONDRAGON, ROBERT
LESLIE, MI 49251

33aNPI1740481167assigned 05/31/2007

33bProvider typeDentist

28Total paid$2K

24GClaims69

24DCodes billed3

24AFirst – last monthAug 2018 – Nov 2018

Compared with peers

Next to other Dentist providers in Michigan

Rank by total paid#795 of 1,033

Median peer was paid$15K

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	69	$2K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1120	Dental cleaning, childProphylaxis - child	51%	28	28	$1K
D1206	Topical application of fluoride varnish	30%	26	26	$650.00
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	19%	15	15	$420.00

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.