Dental
Mandefro, Azaryas
Mandefro, Azaryas was paid $403K by Medicaid between Feb 2019 and Jun 2024, across 19 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 21% of everything it billed.
33Billing provider infoMANDEFRO, AZARYAS
ARNOLD, MO 63010
ARNOLD, MO 63010
33aNPI1881922193assigned 11/24/2009
33bProvider typeDentist
28Total paid$403K
24GClaims16,122
24DCodes billed19
24AFirst – last monthFeb 2019 – Jun 2024
Compared with peers
Next to other Dentist providers in Missouri
Rank by total paid#69 of 284
Median peer was paid$109K
This provider vs. median3.7×
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 | 10,146 | $257K | |
| 2020 | 4,958 | $124K | |
| 2021 | 500 | $8K | |
| 2022 | 153 | $3K | |
| 2023 | 144 | $5K | |
| 2024incomplete | 221 | $6K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 21% | 1,244 | 423 | $85K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 11% | 501 | 222 | $43K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 7.7% | 1,291 | 1,263 | $31K |
| D0150 | Comprehensive oral evaluation - new or established patient | 7.3% | 791 | 772 | $29K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 7.3% | 567 | 239 | $29K |
| D0274 | Bitewings - four radiographic images | 6.9% | 1,276 | 1,221 | $28K |
| D1110 | Prophylaxis - adult | 5.7% | 859 | 844 | $23K |
| D0220 | Intraoral - periapical first radiographic image | 5.7% | 2,473 | 2,368 | $23K |
| D0330 | Panoramic radiographic image | 5.0% | 699 | 680 | $20K |
| D0230 | Intraoral - periapical each additional radiographic image | 4.8% | 2,488 | 2,049 | $19K |
| D1120 | Dental cleaning, childProphylaxis - child | 4.3% | 844 | 842 | $18K |
| D1351 | Sealant - per tooth | 3.7% | 890 | 209 | $15K |
7 more codes
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.