Dental
Johnson, Tessa
Johnson, Tessa was paid $646K by Medicaid between Jun 2022 and Dec 2024, across 19 billing codes. Its largest line is D9999, Unspecified adjunctive procedure, by report — 97% of everything it billed.
33Billing provider infoJOHNSON, TESSA
QUINCY, IL 62301
QUINCY, IL 62301
33aNPI1487613816assigned 03/23/2006
33bProvider typeDentist
28Total paid$646K
24GClaims12,753
24DCodes billed19
24AFirst – last monthJun 2022 – Dec 2024
Compared with peers
Next to other Dentist providers in Illinois
Rank by total paid#249 of 1,099
Median peer was paid$160K
This provider vs. median4.0×
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 | |
|---|---|---|---|
| 2022 | 2,634 | $149K | |
| 2023 | 4,256 | $225K | |
| 2024incomplete | 5,863 | $272K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D9999 | Unspecified adjunctive procedure, by report | 97% | 2,580 | 2,312 | $629K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | <1% | 1,157 | 1,149 | $3K |
| D1110 | Prophylaxis - adult | <1% | 796 | 788 | $3K |
| D1206 | Topical application of fluoride varnish | <1% | 1,360 | 1,346 | $2K |
| D1120 | Dental cleaning, childProphylaxis - child | <1% | 415 | 412 | $2K |
| D1351 | Sealant - per tooth | <1% | 472 | 92 | $2K |
| D0274 | Bitewings - four radiographic images | <1% | 610 | 609 | $1K |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 868 | 448 | $785.40 |
| D0330 | Panoramic radiographic image | <1% | 355 | 345 | $770.45 |
| D0210 | Intraoral - complete series of radiographic images | <1% | 136 | 132 | $546.69 |
| D0603 | <1% | 440 | 435 | $525.00 | |
| D0601 | <1% | 308 | 306 | $465.00 |
7 more codes
| D0602 | <1% | 175 | $360.01 | |
| D0140 | Limited oral evaluation - problem focused | <1% | 419 | $280.78 |
| D0220 | Intraoral - periapical first radiographic image | <1% | 540 | $162.93 |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 41 | $88.41 |
| D0272 | Bitewings - two radiographic images | <1% | 14 | $11.21 |
| D1330 | <1% | 1,306 | $0.01 | |
| D1310 | 0% | 761 | $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.