Jackson, Chelsea

Jackson, Chelsea was paid $8K by Medicaid between Jan 2020 and Apr 2021, across 10 billing codes. Its largest line is D0150, Comprehensive oral evaluation - new or established patient — 27% of everything it billed.

33Billing provider infoJACKSON, CHELSEA
ANTHEM, AZ 85086

33aNPI1235786013assigned 08/26/2019

33bProvider typeDentist

28Total paid$8K

24GClaims358

24DCodes billed10

24AFirst – last monthJan 2020 – Apr 2021

Compared with peers

Next to other Dentist providers in Arizona

Rank by total paid#159 of 468

Median peer was paid$686.85

This provider vs. median12×

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	227	$5K
2021	131	$3K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0150	Comprehensive oral evaluation - new or established patient	27%	84	84	$2K
D0210	Intraoral - complete series of radiographic images	23%	50	50	$2K
D1110	Prophylaxis - adult	17%	38	38	$1K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	12%	54	54	$951.22
D1206	Topical application of fluoride varnish	7.9%	40	40	$630.00
D0274	Bitewings - four radiographic images	3.9%	15	15	$315.00
D0350		3.9%	25	25	$307.75
D1120	Dental cleaning, childProphylaxis - child	3.3%	14	14	$260.00
D0230	Intraoral - periapical each additional radiographic image	1.3%	21	12	$105.00
D0220	Intraoral - periapical first radiographic image	1.1%	17	17	$85.00

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.