Dental
Robertson, Jessica
Robertson, Jessica was paid $21K by Medicaid between Jan 2018 and Aug 2023, across 21 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 29% of everything it billed.
33Billing provider infoROBERTSON, JESSICA
FLAGSTAFF, AZ 86001
FLAGSTAFF, AZ 86001
33aNPI1316041437assigned 09/11/2006
33bProvider typePediatric Dentist
28Total paid$21K
24GClaims13,240
24DCodes billed21
24AFirst – last monthJan 2018 – Aug 2023
Compared with peers
Next to other Pediatric Dentist providers in Arizona
Rank by total paid#117 of 223
Median peer was paid$24K
This provider vs. median0.9×
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 | 6,126 | $1K | |
| 2019 | 6,903 | $18K | |
| 2020 | 153 | $2K | |
| 2021 | 26 | $0.00 | |
| 2023 | 32 | $0.00 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 29% | 254 | 60 | $6K |
| D1120 | Dental cleaning, childProphylaxis - child | 20% | 1,690 | 1,662 | $4K |
| D7140 | Extraction, erupted tooth or exposed root | 14% | 310 | 117 | $3K |
| D1206 | Topical application of fluoride varnish | 11% | 1,906 | 1,867 | $2K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 6.3% | 1,684 | 1,655 | $1K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 4.4% | 258 | 137 | $911.92 |
| D0272 | Bitewings - two radiographic images | 3.8% | 808 | 782 | $798.94 |
| D1351 | Sealant - per tooth | 3.4% | 1,094 | 340 | $714.14 |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.7% | 44 | 42 | $364.41 |
| D0220 | Intraoral - periapical first radiographic image | 1.6% | 563 | 537 | $340.48 |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 1.5% | 431 | 391 | $321.75 |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 1.4% | 126 | 71 | $283.12 |
9 more codes
| D0145 | Oral evaluation for a patient under three years of age | <1% | 34 | $149.80 |
| D1354 | <1% | 541 | $142.50 | |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 261 | $128.40 |
| D0330 | Panoramic radiographic image | <1% | 52 | $95.00 |
| D0140 | Limited oral evaluation - problem focused | <1% | 67 | $68.88 |
| D0274 | Bitewings - four radiographic images | <1% | 12 | $59.98 |
| D1110 | Prophylaxis - adult | <1% | 118 | $47.56 |
| D1330 | 0% | 1,801 | $0.00 | |
| D0603 | 0% | 1,186 | $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.