Petersen, Mark

Petersen, Mark was paid $12K by Medicaid between Feb 2018 and Jun 2021, across 3 billing codes. Its largest line is D0120, dental checkup, returning patient — 59% of everything it billed.

33Billing provider infoPETERSEN, MARK
COXSACKIE, NY 12051

33aNPI1255470365assigned 02/05/2007

33bProvider typeGeneral Practice Dentistry

28Total paid$12K

24GClaims412

24DCodes billed3

24AFirst – last monthFeb 2018 – Jun 2021

Compared with peers

Next to other General Practice Dentistry providers in New York

Rank by total paid#1,534 of 2,184

Median peer was paid$54K

This provider vs. median0.2×

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
2018	169	$5K
2019	175	$5K
2020	12	$308.00
2021	56	$2K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	59%	274	272	$7K
D1110	Prophylaxis - adult	38%	99	99	$4K
D0230	Intraoral - periapical each additional radiographic image	3.3%	39	38	$384.00

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.