Medina, Jaqueline

Medina, Jaqueline was paid $1K by Medicaid between Apr 2023 and Jun 2023, across 5 billing codes. Its largest line is D1208, Topical application of fluoride, excluding varnish — 47% of everything it billed.

33Billing provider infoMEDINA, JAQUELINE
PORT ARTHUR, TX 77640

33aNPI1477167419assigned 09/08/2020

33bProvider typeGeneral Practice Dentistry

28Total paid$1K

24GClaims154

24DCodes billed5

24AFirst – last monthApr 2023 – Jun 2023

Compared with peers

Next to other General Practice Dentistry providers in Texas

Rank by total paid#2,372 of 2,774

Median peer was paid$43K

This provider vs. median0.0×

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
2023	154	$1K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1208	Topical application of fluoride, excluding varnish	47%	41	41	$588.00
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	28%	13	13	$346.20
D0220	Intraoral - periapical first radiographic image	13%	14	14	$163.28
D0230	Intraoral - periapical each additional radiographic image	12%	13	13	$149.63
D0603		0%	73	73	$0.00

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.