1144346909

1144346909 was paid $58K by Medicaid between May 2018 and Oct 2021, across 10 billing codes. Its largest line is D1110, Prophylaxis - adult — 53% of everything it billed.

33Billing provider info1144346909

33aNPI1144346909

33bProvider type—

28Total paid$58K

24GClaims1,846

24DCodes billed10

24AFirst – last monthMay 2018 – Oct 2021

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	61	$4K
2019	363	$14K
2020	684	$18K
2021	738	$23K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1110	Prophylaxis - adult	53%	562	561	$31K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	15%	316	315	$9K
D0274	Bitewings - four radiographic images	13%	268	268	$7K
D0150	Comprehensive oral evaluation - new or established patient	11%	219	219	$6K
D0210	Intraoral - complete series of radiographic images	3.8%	41	41	$2K
D1208	Topical application of fluoride, excluding varnish	3.1%	128	128	$2K
D1120	Dental cleaning, childProphylaxis - child	1.0%	14	14	$602.00
D0220	Intraoral - periapical first radiographic image	<1%	26	26	$348.88
D1999		0%	240	194	$0.00
D9997		0%	32	24	$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.