Boelter, Terry

Boelter, Terry was paid $14K by Medicaid between Jan 2020 and Nov 2021, across 4 billing codes. Its largest line is D0120, dental checkup, returning patient — 34% of everything it billed.

33Billing provider infoBOELTER, TERRY
SANBORN, IA 51248

33aNPI1568538775assigned 11/28/2006

33bProvider typeGeneral Practice Dentistry

28Total paid$14K

24GClaims486

24DCodes billed4

24AFirst – last monthJan 2020 – Nov 2021

Compared with peers

Next to other General Practice Dentistry providers in Iowa

Rank by total paid#251 of 437

Median peer was paid$22K

This provider vs. median0.6×

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
2020	416	$12K
2021	70	$2K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	34%	189	185	$5K
D1110	Prophylaxis - adult	30%	105	102	$4K
D1206	Topical application of fluoride varnish	24%	154	151	$3K
D1120	Dental cleaning, childProphylaxis - child	13%	38	38	$2K

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.