Dental
Bouroncle, Sebastian
Bouroncle, Sebastian was paid $627K by Medicaid between Feb 2019 and Sep 2024, across 25 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 23% of everything it billed.
33Billing provider infoBOURONCLE, SEBASTIAN
STAFFORD, VA 22554
STAFFORD, VA 22554
33aNPI1932245511assigned 01/30/2007
33bProvider typeGeneral Practice Dentistry
28Total paid$627K
24GClaims22,877
24DCodes billed25
24AFirst – last monthFeb 2019 – Sep 2024
Compared with peers
Next to other General Practice Dentistry providers in Virginia
Rank by total paid#61 of 549
Median peer was paid$29K
This provider vs. median21×
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 | 13 | $221.65 | |
| 2020 | 2,985 | $46K | |
| 2021 | 3,570 | $94K | |
| 2022 | 5,456 | $303K | |
| 2023 | 5,957 | $185K | |
| 2024incomplete | 4,896 | $0.00 |
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 | 23% | 2,344 | 1,307 | $146K |
| D1110 | Prophylaxis - adult | 11% | 2,471 | 2,344 | $71K |
| D2740 | Crown - porcelain/ceramic | 9.5% | 286 | 210 | $60K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 8.9% | 570 | 389 | $56K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 7.7% | 997 | 614 | $48K |
| D2950 | 5.4% | 391 | 308 | $34K | |
| D0150 | Comprehensive oral evaluation - new or established patient | 5.0% | 1,596 | 1,399 | $32K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 4.7% | 2,379 | 2,292 | $30K |
| D0274 | Bitewings - four radiographic images | 4.5% | 1,726 | 1,636 | $28K |
| D0220 | Intraoral - periapical first radiographic image | 2.8% | 2,851 | 2,406 | $17K |
| D0210 | Intraoral - complete series of radiographic images | 2.6% | 532 | 414 | $16K |
| D0140 | Limited oral evaluation - problem focused | 2.6% | 1,049 | 932 | $16K |
13 more codes
| D1206 | Topical application of fluoride varnish | 2.5% | 1,053 | $16K |
| D0230 | Intraoral - periapical each additional radiographic image | 2.5% | 2,561 | $15K |
| D3330 | Endodontic therapy, molar tooth (excluding final restoration) | 1.7% | 12 | $11K |
| D4910 | 1.5% | 439 | $10K | |
| D1120 | Dental cleaning, child | 1.5% | 354 | $10K |
| D9610 | 1.2% | 875 | $7K | |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | <1% | 16 | $2K |
| D2331 | <1% | 36 | $2K | |
| D0330 | Panoramic radiographic image | <1% | 38 | $912.47 |
| D3120 | <1% | 53 | $813.62 | |
| D7140 | Extraction, erupted tooth or exposed root | 0% | 105 | $0.00 |
| D4341 | 0% | 128 | $0.00 | |
| D1999 | 0% | 15 | $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.