1548392012

1548392012 was paid $391K by Medicaid between Sep 2020 and Nov 2021, across 5 billing codes. Its largest line is D7210, Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth — 85% of everything it billed.

33Billing provider info1548392012

33aNPI1548392012

33bProvider type—

28Total paid$391K

24GClaims1,988

24DCodes billed5

24AFirst – last monthSep 2020 – Nov 2021

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
2020	587	$121K
2021	1,401	$270K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth	85%	1,618	354	$330K
D7240	Removal of impacted tooth - completely bony	8.8%	79	31	$35K
D0140	Limited oral evaluation - problem focused	2.9%	188	188	$11K
D0330	Panoramic radiographic image	2.2%	74	74	$9K
D0367		1.6%	29	29	$6K

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.