Dental
Tice, Johnny
Tice, Johnny was paid $23K by Medicaid between Jan 2018 and Jan 2018, across 14 billing codes. Its largest line is D0150, Comprehensive oral evaluation - new or established patient — 15% of everything it billed.
33Billing provider infoTICE, JOHNNY
HOBBS, NM 88240
HOBBS, NM 88240
33aNPI1124541164assigned 07/21/2017
33bProvider typeDentist
28Total paid$23K
24GClaims889
24DCodes billed14
24AFirst – last monthJan 2018 – Jan 2018
Compared with peers
Next to other Dentist providers in New Mexico
Rank by total paid#109 of 179
Median peer was paid$47K
This provider vs. median0.5×
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 | |
|---|---|---|---|
| 2018 | 889 | $23K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0150 | Comprehensive oral evaluation - new or established patient | 15% | 100 | 100 | $3K |
| D1110 | Prophylaxis - adult | 12% | 58 | 58 | $3K |
| D1208 | Topical application of fluoride, excluding varnish | 10% | 129 | 129 | $2K |
| D1120 | Dental cleaning, childProphylaxis - child | 9.5% | 70 | 70 | $2K |
| D0274 | Bitewings - four radiographic images | 9.3% | 74 | 74 | $2K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 7.9% | 25 | 13 | $2K |
| D0330 | Panoramic radiographic image | 7.1% | 31 | 31 | $2K |
| D1351 | Sealant - per tooth | 6.2% | 60 | 12 | $1K |
| D0220 | Intraoral - periapical first radiographic image | 6.0% | 123 | 123 | $1K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 5.0% | 21 | 13 | $1K |
| D0230 | Intraoral - periapical each additional radiographic image | 5.0% | 119 | 119 | $1K |
| D0272 | Bitewings - two radiographic images | 3.3% | 38 | 38 | $746.70 |
2 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.