Dental
Boerema, Melissa
Boerema, Melissa was paid $62K by Medicaid between Feb 2018 and Mar 2020, across 12 billing codes. Its largest line is D1206, Topical application of fluoride varnish — 19% of everything it billed.
33Billing provider infoBOEREMA, MELISSA
BUTLER, MO 64730
BUTLER, MO 64730
33aNPI1457640641assigned 03/29/2011
33bProvider typeGeneral Practice Dentistry
28Total paid$62K
24GClaims1,373
24DCodes billed12
24AFirst – last monthFeb 2018 – Mar 2020
Compared with peers
Next to other General Practice Dentistry providers in Missouri
Rank by total paid#146 of 260
Median peer was paid$78K
This provider vs. median0.8×
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 | 799 | $43K | |
| 2019 | 338 | $12K | |
| 2020 | 236 | $6K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1206 | Topical application of fluoride varnish | 19% | 327 | 304 | $12K |
| D0330 | Panoramic radiographic image | 13% | 75 | 71 | $8K |
| D1120 | Dental cleaning, childProphylaxis - child | 13% | 187 | 170 | $8K |
| D0150 | Comprehensive oral evaluation - new or established patient | 12% | 121 | 103 | $7K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 9.1% | 149 | 140 | $6K |
| D0274 | Bitewings - four radiographic images | 8.9% | 121 | 107 | $6K |
| D0220 | Intraoral - periapical first radiographic image | 6.2% | 174 | 165 | $4K |
| D2150 | Silver amalgam - two surfaces, primary or permanent | 5.1% | 33 | 13 | $3K |
| D2140 | 4.6% | 41 | 15 | $3K | |
| D0230 | Intraoral - periapical each additional radiographic image | 4.2% | 84 | 62 | $3K |
| D1110 | Prophylaxis - adult | 2.0% | 14 | 12 | $1K |
| D0272 | Bitewings - two radiographic images | 1.8% | 47 | 41 | $1K |
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.