Clark, Jacob

Clark, Jacob was paid $119K by Medicaid between Nov 2018 and Dec 2024, across 16 billing codes. Its largest line is D1110, Prophylaxis - adult — 22% of everything it billed.

33Billing provider infoCLARK, JACOB
GREENVILLE, KY 42345

33aNPI1568956621assigned 06/21/2018

33bProvider typeGeneral Practice Dentistry

28Total paid$119K

24GClaims3,896

24DCodes billed16

24AFirst – last monthNov 2018 – Dec 2024

Compared with peers

Next to other General Practice Dentistry providers in Kentucky

Rank by total paid#217 of 462

Median peer was paid$106K

This provider vs. median1.1×

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	90	$2K
2019	220	$5K
2020	157	$4K
2021	900	$22K
2024incomplete	2,529	$86K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1110	Prophylaxis - adult	22%	492	487	$27K
D1120	Dental cleaning, childProphylaxis - child	19%	427	425	$23K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	15%	667	663	$18K
D0150	Comprehensive oral evaluation - new or established patient	8.4%	433	425	$10K
D0274	Bitewings - four radiographic images	7.3%	309	304	$9K
D1206	Topical application of fluoride varnish	6.2%	398	396	$7K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	4.5%	87	66	$5K
D0330	Panoramic radiographic image	4.4%	132	130	$5K
D1321		3.8%	308	307	$4K
D1208	Topical application of fluoride, excluding varnish	3.2%	285	279	$4K
D7140	Extraction, erupted tooth or exposed root	1.7%	57	32	$2K
D0220	Intraoral - periapical first radiographic image	1.1%	147	140	$1K

4 more codes

D0272	Bitewings - two radiographic images	1.1%	56	$1K
D2391	Resin-based composite - one surface, posterior, primary or permanent	<1%	29	$1K
D0140	Limited oral evaluation - problem focused	<1%	31	$910.80
D0230	Intraoral - periapical each additional radiographic image	<1%	38	$162.06

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.