Van, Jackson

Van, Jackson was paid $814.00 by Medicaid between Oct 2024 and Dec 2024, across 10 billing codes. Its largest line is D0220, Intraoral - periapical first radiographic image — 19% of everything it billed.

33Billing provider infoVAN, JACKSON
GLADSTONE, OR 97027

33aNPI1083442164assigned 07/22/2024

33bProvider typeGeneral Practice Dentistry

28Total paid$814.00

24GClaims339

24DCodes billed10

24AFirst – last monthOct 2024 – Dec 2024

Compared with peers

Next to other General Practice Dentistry providers in Oregon

Rank by total paid#231 of 311

Median peer was paid$6K

This provider vs. median0.1×

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
2024incomplete	339	$814.00

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0220	Intraoral - periapical first radiographic image	19%	61	61	$156.00
D0330	Panoramic radiographic image	19%	34	34	$156.00
D0150	Comprehensive oral evaluation - new or established patient	19%	29	29	$152.00
D0274	Bitewings - four radiographic images	18%	32	32	$145.00
D0140	Limited oral evaluation - problem focused	13%	12	12	$105.00
D0603		6.8%	35	35	$55.00
D0230	Intraoral - periapical each additional radiographic image	5.5%	33	33	$45.00
D1310		0%	35	35	$0.00
D1330		0%	43	43	$0.00
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	0%	25	17	$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.