Polk, Jason

Polk, Jason was paid $26K by Medicaid between Mar 2021 and May 2021, across 9 billing codes. Its largest line is D1120, dental cleaning, child — 20% of everything it billed.

33Billing provider infoPOLK, JASON
RICHLAND, MS 39218

33aNPI1033131487assigned 07/24/2006

33bProvider typeGeneral Practice Dentistry

28Total paid$26K

24GClaims769

24DCodes billed9

24AFirst – last monthMar 2021 – May 2021

Compared with peers

Next to other General Practice Dentistry providers in Mississippi

Rank by total paid#253 of 379

Median peer was paid$78K

This provider vs. median0.3×

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
2021	769	$26K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1120	Dental cleaning, childProphylaxis - child	20%	186	176	$5K
D2391	Resin-based composite - one surface, posterior, primary or permanent	16%	50	22	$4K
D0150	Comprehensive oral evaluation - new or established patient	13%	84	84	$3K
D1208	Topical application of fluoride, excluding varnish	12%	186	175	$3K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	11%	110	100	$3K
D0274	Bitewings - four radiographic images	11%	82	79	$3K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	7.9%	20	13	$2K
D0330	Panoramic radiographic image	7.6%	37	36	$2K
D9230	Inhalation of nitrous oxide / analgesia, anxiolysis	1.6%	14	13	$409.20

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.