Dental
Jackson, Andrea
Jackson, Andrea was paid $928.35 by Medicaid between Oct 2020 and Oct 2020, across 2 billing codes. Its largest line is D1120, dental cleaning, child — 62% of everything it billed.
33Billing provider infoJACKSON, ANDREA
CLINTON, MD 20735
CLINTON, MD 20735
33aNPI1578707204assigned 04/24/2009
33bProvider typeProsthodontist
28Total paid$928.35
24GClaims28
24DCodes billed2
24AFirst – last monthOct 2020 – Oct 2020
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 | 28 | $928.35 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 62% | 15 | 15 | $578.07 |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 38% | 13 | 13 | $350.28 |
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.