Dental
Tessema, Derejew
Tessema, Derejew was paid $66K by Medicaid between May 2020 and Dec 2022, across 14 billing codes. Its largest line is D0150, Comprehensive oral evaluation - new or established patient — 22% of everything it billed.
33Billing provider infoTESSEMA, DEREJEW
WASHINGTON, DC 20011
WASHINGTON, DC 20011
33aNPI1215380548assigned 07/21/2016
33bProvider typeDentist
28Total paid$66K
24GClaims3,251
24DCodes billed14
24AFirst – last monthMay 2020 – Dec 2022
Compared with peers
Next to other Dentist providers in District of Columbia
Rank by total paid#24 of 66
Median peer was paid$30K
This provider vs. median2.2×
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 | 829 | $13K | |
| 2021 | 1,416 | $27K | |
| 2022 | 1,006 | $26K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0150 | Comprehensive oral evaluation - new or established patient | 22% | 640 | 639 | $14K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 19% | 143 | 66 | $13K |
| D0330 | Panoramic radiographic image | 16% | 337 | 335 | $11K |
| D1110 | Prophylaxis - adult | 11% | 226 | 223 | $7K |
| D0274 | Bitewings - four radiographic images | 11% | 547 | 543 | $7K |
| D0140 | Limited oral evaluation - problem focused | 5.9% | 239 | 231 | $4K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 5.5% | 39 | 24 | $4K |
| D0230 | Intraoral - periapical each additional radiographic image | 2.5% | 532 | 229 | $2K |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 2.3% | 39 | 25 | $2K |
| D0220 | Intraoral - periapical first radiographic image | 2.0% | 287 | 280 | $1K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 1.5% | 62 | 62 | $987.04 |
| D0210 | Intraoral - complete series of radiographic images | 1.4% | 49 | 44 | $908.00 |
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.