Clifton, Jack

Clifton, Jack was paid $3K by Medicaid between Feb 2018 and Jul 2019, across 3 billing codes. Its largest line is D1206, Topical application of fluoride varnish — 53% of everything it billed.

33Billing provider infoCLIFTON, JACK
STEVENSON, WA 98648

33aNPI1568597631assigned 02/22/2007

33bProvider typeGeneral Practice Dentistry

28Total paid$3K

24GClaims147

24DCodes billed3

24AFirst – last monthFeb 2018 – Jul 2019

Compared with peers

Next to other General Practice Dentistry providers in Washington

Rank by total paid#220 of 319

Median peer was paid$22K

This provider vs. median0.1×

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	72	$1K
2019	75	$1K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1206	Topical application of fluoride varnish	53%	92	89	$1K
D1120	Dental cleaning, childProphylaxis - child	24%	28	27	$620.46
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	22%	27	27	$566.44

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.