Dental
Derek a Siemon DDS LLC
Derek a Siemon DDS LLC was paid $22K by Medicaid between Jan 2018 and Mar 2019, across 5 billing codes. Its largest line is D0120, dental checkup, returning patient — 35% of everything it billed.
33Billing provider infoDEREK A SIEMON DDS LLC
ANNAPOLIS, MD 21401
ANNAPOLIS, MD 21401
33aNPI1497825152assigned 11/09/2006
33bProvider typeGeneral Practice Dentistry
28Total paid$22K
24GClaims784
24DCodes billed5
24AFirst – last monthJan 2018 – Mar 2019
Compared with peers
Next to other General Practice Dentistry providers in Maryland
Rank by total paid#358 of 598
Median peer was paid$42K
This provider vs. median0.5×
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 | 623 | $17K | |
| 2019 | 161 | $5K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 35% | 267 | 265 | $8K |
| D1208 | Topical application of fluoride, excluding varnish | 28% | 266 | 264 | $6K |
| D1110 | Prophylaxis - adult | 18% | 66 | 66 | $4K |
| D1120 | Dental cleaning, childProphylaxis - child | 16% | 85 | 83 | $4K |
| D1330 | 2.7% | 100 | 100 | $600.00 |
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.
From NPPES
Who's on the registration
Authorized officialSIEMON, DEREK (OWNER)