Pezeshk, Mo

Pezeshk, Mo was paid $26K by Medicaid between Jan 2018 and Apr 2019, across 12 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 17% of everything it billed.

33Billing provider infoPEZESHK, MO
ROUND ROCK, TX 78681

33aNPI1164787230assigned 07/05/2012

33bProvider typeDentist

28Total paid$26K

24GClaims716

24DCodes billed12

24AFirst – last monthJan 2018 – Apr 2019

Compared with peers

Next to other Dentist providers in Texas

Rank by total paid#887 of 1,678

Median peer was paid$35K

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
2018	491	$20K
2019	225	$6K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	17%	29	12	$4K
D0330	Panoramic radiographic image	16%	53	49	$4K
D1206	Topical application of fluoride varnish	13%	132	129	$4K
D1120	Dental cleaning, childProphylaxis - child	11%	59	59	$3K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	8.6%	80	77	$2K
D0220	Intraoral - periapical first radiographic image	7.7%	113	106	$2K
D1110	Prophylaxis - adult	7.7%	54	46	$2K
D0150	Comprehensive oral evaluation - new or established patient	7.0%	46	41	$2K
D0230	Intraoral - periapical each additional radiographic image	5.1%	100	86	$1K
D0272	Bitewings - two radiographic images	2.8%	24	24	$726.63
D0140	Limited oral evaluation - problem focused	2.7%	14	14	$717.60
D0274	Bitewings - four radiographic images	1.9%	12	12	$499.52

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.