Plicka, Jefferson

Plicka, Jefferson was paid $46K by Medicaid between Sep 2018 and Dec 2020, across 11 billing codes. Its largest line is D0150, Comprehensive oral evaluation - new or established patient — 58% of everything it billed.

33Billing provider infoPLICKA, JEFFERSON
SANTA BARBARA, CA 93110

33aNPI1346529880assigned 08/16/2011

33bProvider typeDentist

28Total paid$46K

24GClaims1,524

24DCodes billed11

24AFirst – last monthSep 2018 – Dec 2020

Compared with peers

Next to other Dentist providers in California

Rank by total paid#1,569 of 2,314

Median peer was paid$185K

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	92	$4K
2019	286	$6K
2020	1,146	$36K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0150	Comprehensive oral evaluation - new or established patient	58%	145	144	$27K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	25%	77	77	$12K
D2150	Silver amalgam - two surfaces, primary or permanent	8.5%	38	13	$4K
D1110	Prophylaxis - adult	3.9%	44	44	$2K
D0274	Bitewings - four radiographic images	1.9%	189	189	$856.98
D0330	Panoramic radiographic image	<1%	72	72	$455.49
D0210	Intraoral - complete series of radiographic images	<1%	38	37	$228.37
D1120	Dental cleaning, childProphylaxis - child	<1%	61	60	$201.84
D0220	Intraoral - periapical first radiographic image	<1%	227	226	$114.14
D1206	Topical application of fluoride varnish	<1%	136	136	$64.40
D0230	Intraoral - periapical each additional radiographic image	0%	497	200	$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.