Rivergate Dental Group

Rivergate Dental Group was paid $246K by Medicaid between Jan 2018 and Oct 2021, across 15 billing codes. Its largest line is D1110, Prophylaxis - adult — 21% of everything it billed.

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	2,347	$114K
2019	1,854	$57K
2020	1,297	$37K
2021	1,234	$39K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1110	Prophylaxis - adult	21%	1,317	1,275	$51K
D2752		16%	88	55	$38K
D1208	Topical application of fluoride, excluding varnish	12%	1,549	1,497	$30K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	11%	362	194	$26K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	10%	1,118	1,093	$25K
D0210	Intraoral - complete series of radiographic images	8.8%	389	373	$22K
D0274	Bitewings - four radiographic images	8.4%	813	788	$21K
D0150	Comprehensive oral evaluation - new or established patient	5.9%	556	534	$14K
D3330	Endodontic therapy, molar tooth (excluding final restoration)	3.1%	16	12	$8K
D0220	Intraoral - periapical first radiographic image	1.3%	278	264	$3K
D1120	Dental cleaning, childProphylaxis - child	1.2%	94	94	$3K
D2391	Resin-based composite - one surface, posterior, primary or permanent	<1%	39	27	$2K

3 more codes

D2393	Resin-based composite - three surfaces, posterior, primary or permanent	<1%	24	$2K
D0330	Panoramic radiographic image	<1%	18	$595.49
D1999		0%	71	$0.00

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 officialFRAZIER, RODERICK (OWNER)