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NPI 1386860153
NPI deactivated
1386860153
1386860153 was paid $282K by Medicaid between Jan 2018 and Jul 2024, across 14 billing codes. Its largest line is D2752, — 29% of everything it billed.
33Billing provider info1386860153
33aNPI1386860153
33bProvider type—
28Total paid$282K
24GClaims8,347
24DCodes billed14
24AFirst – last monthJan 2018 – Jul 2024
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 | 1,721 | $36K | |
| 2019 | 1,516 | $33K | |
| 2020 | 598 | $20K | |
| 2021 | 921 | $54K | |
| 2022 | 1,200 | $48K | |
| 2023 | 1,405 | $49K | |
| 2024incomplete | 986 | $41K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2752 | 29% | 265 | 147 | $83K | |
| D1110 | Prophylaxis - adult | 17% | 1,429 | 1,331 | $47K |
| D0140 | Limited oral evaluation - problem focused | 13% | 1,408 | 1,222 | $35K |
| D1208 | Topical application of fluoride, excluding varnish | 8.8% | 1,763 | 1,705 | $25K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 8.3% | 1,388 | 1,294 | $23K |
| D3330 | Endodontic therapy, molar tooth (excluding final restoration) | 7.8% | 46 | 41 | $22K |
| D0274 | Bitewings - four radiographic images | 7.2% | 973 | 904 | $20K |
| D1120 | Dental cleaning, childProphylaxis - child | 3.2% | 339 | 331 | $9K |
| D0330 | Panoramic radiographic image | 1.9% | 117 | 115 | $5K |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.5% | 202 | 198 | $4K |
| D0272 | Bitewings - two radiographic images | 1.2% | 200 | 196 | $3K |
| D2161 | 1.2% | 51 | 42 | $3K |
2 more codes
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.