Dental
Moore, Stephen
Moore, Stephen was paid $109K by Medicaid between Jan 2018 and Nov 2018, across 20 billing codes. Its largest line is D1351, Sealant - per tooth — 24% of everything it billed.
33Billing provider infoMOORE, STEPHEN
WICHITA, KS 67206
WICHITA, KS 67206
33aNPI1376519439assigned 02/27/2006
33bProvider typePediatric Dentist
28Total paid$109K
24GClaims4,465
24DCodes billed20
24AFirst – last monthJan 2018 – Nov 2018
Compared with peers
Next to other Pediatric Dentist providers in Kansas
Rank by total paid#27 of 41
Median peer was paid$505K
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 | 4,465 | $109K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1351 | Sealant - per tooth | 24% | 1,104 | 226 | $27K |
| D1120 | Dental cleaning, childProphylaxis - child | 14% | 543 | 541 | $16K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 10% | 556 | 556 | $11K |
| D1208 | Topical application of fluoride, excluding varnish | 8.4% | 602 | 583 | $9K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 7.6% | 127 | 66 | $8K |
| D1206 | Topical application of fluoride varnish | 5.2% | 356 | 341 | $6K |
| D1110 | Prophylaxis - adult | 4.3% | 117 | 117 | $5K |
| D0330 | Panoramic radiographic image | 4.1% | 113 | 113 | $5K |
| D0272 | Bitewings - two radiographic images | 3.9% | 225 | 225 | $4K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 3.4% | 52 | 31 | $4K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 2.6% | 26 | 12 | $3K |
| D0274 | Bitewings - four radiographic images | 2.2% | 86 | 86 | $2K |
8 more codes
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 2.0% | 114 | $2K |
| D0230 | Intraoral - periapical each additional radiographic image | 1.4% | 161 | $2K |
| D0140 | Limited oral evaluation - problem focused | 1.3% | 50 | $1K |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.2% | 46 | $1K |
| D0220 | Intraoral - periapical first radiographic image | <1% | 95 | $1K |
| D0240 | <1% | 65 | $1K | |
| D9420 | <1% | 13 | $900.00 | |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 14 | $319.00 |
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.