SEBASTIAN BOURONCLE DDS-1 PLLC
NPI: 1740667799
· WOODBRIDGE, VA 22191
· 122300000X
$866K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
501 |
$13K |
| 2019 |
702 |
$13K |
| 2020 |
652 |
$9K |
| 2021 |
2,457 |
$121K |
| 2022 |
7,364 |
$511K |
| 2023 |
7,905 |
$199K |
| 2024 |
4,334 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D2392 |
|
2,319 |
1,144 |
$159K |
| D2740 |
|
551 |
383 |
$153K |
| D1110 |
|
2,144 |
2,101 |
$72K |
| D2393 |
|
609 |
374 |
$60K |
| D2950 |
|
659 |
513 |
$58K |
| D0210 |
|
978 |
871 |
$50K |
| D2391 |
|
587 |
359 |
$38K |
| D0120 |
|
2,638 |
2,583 |
$37K |
| D0150 |
|
1,500 |
1,400 |
$37K |
| D9610 |
|
2,549 |
2,386 |
$34K |
| D0274 |
|
1,318 |
1,281 |
$24K |
| D1208 |
|
1,334 |
1,315 |
$21K |
| D0220 |
|
2,616 |
2,391 |
$20K |
| D1120 |
|
646 |
636 |
$18K |
| D4910 |
|
509 |
505 |
$17K |
| D3320 |
|
31 |
24 |
$13K |
| D0230 |
|
1,710 |
1,401 |
$13K |
| D0140 |
|
711 |
685 |
$12K |
| D3330 |
|
32 |
26 |
$11K |
| D1351 |
|
114 |
28 |
$5K |
| D4355 |
|
57 |
57 |
$4K |
| D9920 |
|
62 |
62 |
$4K |
| D7210 |
|
24 |
12 |
$3K |
| D2394 |
|
15 |
12 |
$2K |
| D2331 |
|
14 |
13 |
$1K |
| D4341 |
|
188 |
74 |
$0.00 |