Dental
Simmons, Mary
Simmons, Mary was paid $773.00 by Medicaid between Mar 2018 and Mar 2018, across 2 billing codes. Its largest line is D0120, dental checkup, returning patient — 58% of everything it billed.
33Billing provider infoSIMMONS, MARY
PORT SANILAC, MI 48469
PORT SANILAC, MI 48469
33aNPI1366420762assigned 01/05/2006
33bProvider typeGeneral Practice Dentistry
28Total paid$773.00
24GClaims33
24DCodes billed2
24AFirst – last monthMar 2018 – Mar 2018
Compared with peers
Next to other General Practice Dentistry providers in Michigan
Rank by total paid#1,340 of 1,554
Median peer was paid$15K
This provider vs. median0.1×
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 | 33 | $773.00 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 58% | 18 | 18 | $448.00 |
| D1206 | Topical application of fluoride varnish | 42% | 15 | 15 | $325.00 |
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.