Dental
Dewaal, Benjamin
Dewaal, Benjamin was paid $362K by Medicaid between Jan 2018 and Jul 2020, across 18 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 27% of everything it billed.
33Billing provider infoDEWAAL, BENJAMIN
POTOSI, MO 63664
POTOSI, MO 63664
33aNPI1801182704assigned 06/20/2011
33bProvider typeGeneral Practice Dentistry
28Total paid$362K
24GClaims7,256
24DCodes billed18
24AFirst – last monthJan 2018 – Jul 2020
Compared with peers
Next to other General Practice Dentistry providers in Missouri
Rank by total paid#50 of 260
Median peer was paid$78K
This provider vs. median4.6×
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 | 2,362 | $152K | |
| 2019 | 3,844 | $163K | |
| 2020 | 1,050 | $48K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 27% | 570 | 246 | $96K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 15% | 468 | 283 | $56K |
| D1120 | Dental cleaning, childProphylaxis - child | 14% | 1,258 | 1,239 | $49K |
| D1206 | Topical application of fluoride varnish | 11% | 1,579 | 1,547 | $38K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 5.0% | 611 | 605 | $18K |
| D1110 | Prophylaxis - adult | 4.2% | 308 | 294 | $15K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 4.1% | 146 | 98 | $15K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 3.8% | 377 | 341 | $14K |
| D0272 | Bitewings - two radiographic images | 3.7% | 508 | 504 | $13K |
| D0220 | Intraoral - periapical first radiographic image | 3.5% | 685 | 649 | $13K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.3% | 182 | 181 | $8K |
| D0330 | Panoramic radiographic image | 2.3% | 157 | 156 | $8K |
6 more codes
| D7140 | Extraction, erupted tooth or exposed root | 1.6% | 89 | $6K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 15 | $3K |
| D0274 | Bitewings - four radiographic images | <1% | 101 | $3K |
| D0140 | Limited oral evaluation - problem focused | <1% | 44 | $3K |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 123 | $2K |
| D1351 | Sealant - per tooth | <1% | 35 | $775.00 |
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.