Dental
Black, Stacy
Black, Stacy was paid $33K by Medicaid between Dec 2020 and Jul 2024, across 6 billing codes. Its largest line is D0120, dental checkup, returning patient — 43% of everything it billed.
33Billing provider infoBLACK, STACY
RUSK, TX 75785
RUSK, TX 75785
33aNPI1063423085assigned 08/11/2006
33bProvider typeGeneral Practice Dentistry
28Total paid$33K
24GClaims2,011
24DCodes billed6
24AFirst – last monthDec 2020 – Jul 2024
Compared with peers
Next to other General Practice Dentistry providers in Texas
Rank by total paid#1,505 of 2,774
Median peer was paid$43K
This provider vs. median0.8×
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 | |
|---|---|---|---|
| 2020 | 80 | $2K | |
| 2021 | 711 | $13K | |
| 2022 | 587 | $10K | |
| 2023 | 459 | $7K | |
| 2024incomplete | 174 | $2K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 43% | 520 | 515 | $14K |
| D1110 | Prophylaxis - adult | 26% | 163 | 163 | $9K |
| D1208 | Topical application of fluoride, excluding varnish | 23% | 530 | 526 | $8K |
| D1120 | Dental cleaning, childProphylaxis - child | 5.0% | 46 | 46 | $2K |
| D4910 | 2.4% | 25 | 25 | $797.50 | |
| D0603 | 0% | 727 | 723 | $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.