Moss, Jack

Moss, Jack was paid $2K by Medicaid between Mar 2019 and Apr 2019, across 4 billing codes. Its largest line is D1110, Prophylaxis - adult — 41% of everything it billed.

33Billing provider infoMOSS, JACK
ARVADA, CO 80003

33aNPI1518077585assigned 08/30/2006

33bProvider typeGeneral Practice Dentistry

28Total paid$2K

24GClaims77

24DCodes billed4

24AFirst – last monthMar 2019 – Apr 2019

Compared with peers

Next to other General Practice Dentistry providers in Colorado

Rank by total paid#469 of 521

Median peer was paid$53K

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
2019	77	$2K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1110	Prophylaxis - adult	41%	22	18	$883.52
D0150	Comprehensive oral evaluation - new or established patient	26%	15	13	$565.80
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	25%	25	23	$547.00
D0220	Intraoral - periapical first radiographic image	8.3%	15	13	$180.30

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.