1467548990

1467548990 was paid $1.41M by Medicaid between Jan 2018 and Mar 2023, across 21 billing codes. Its largest line is D1110, Prophylaxis - adult — 15% of everything it billed.

33Billing provider info1467548990

33aNPI1467548990

33bProvider type—

28Total paid$1.41M

24GClaims71,674

24DCodes billed21

24AFirst – last monthJan 2018 – Mar 2023

Auditor's notes

Automated statistical signals. Not evidence of fraud — how these are computed.

OIG exclusionListed on the federal exclusion list (08/20/2024).

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	15,169	$267K
2019	24,234	$424K
2020	9,912	$238K
2021	11,582	$239K
2022	10,658	$237K
2023	119	$2K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1110	Prophylaxis - adult	15%	8,996	7,280	$204K
D2140		13%	7,007	2,033	$189K
D1999		13%	10,979	5,192	$177K
D0330	Panoramic radiographic image	10%	5,822	4,494	$143K
D0150	Comprehensive oral evaluation - new or established patient	7.1%	5,627	4,462	$100K
D7140	Extraction, erupted tooth or exposed root	6.7%	3,202	1,651	$95K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	6.1%	7,121	6,110	$86K
D1208	Topical application of fluoride, excluding varnish	5.8%	6,036	4,575	$81K
D0272	Bitewings - two radiographic images	5.6%	6,490	5,141	$78K
D1120	Dental cleaning, childProphylaxis - child	5.2%	4,327	3,315	$73K
D2150	Silver amalgam - two surfaces, primary or permanent	4.6%	2,024	954	$65K
D2160		3.3%	1,178	712	$46K

9 more codes

D0140	Limited oral evaluation - problem focused	2.2%	1,947	$31K
D2335		1.5%	418	$21K
D2161		<1%	140	$8K
D2391	Resin-based composite - one surface, posterior, primary or permanent	<1%	171	$4K
D2330		<1%	71	$2K
D2940		<1%	55	$2K
D2332		<1%	24	$864.96
D2331		<1%	23	$658.50
D3220	Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction	<1%	16	$571.20

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.