Wallace, Mark

Wallace, Mark was paid $44K by Medicaid between Mar 2018 and Mar 2020, across 6 billing codes. Its largest line is D1206, Topical application of fluoride varnish — 96% of everything it billed.

33Billing provider infoWALLACE, MARK
SALT LAKE CITY, UT 84116

33aNPI1669467213assigned 09/20/2005

33bProvider typeGeneral Practice Dentistry

28Total paid$44K

24GClaims2,545

24DCodes billed6

24AFirst – last monthMar 2018 – Mar 2020

Compared with peers

Next to other General Practice Dentistry providers in Utah

Rank by total paid#84 of 225

Median peer was paid$21K

This provider vs. median2.1×

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	751	$12K
2019	1,074	$16K
2020	720	$17K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1206	Topical application of fluoride varnish	96%	1,083	1,081	$42K
D1351	Sealant - per tooth	1.8%	1,077	368	$795.85
D0190		1.1%	13	13	$468.00
D0220	Intraoral - periapical first radiographic image	<1%	177	172	$366.03
D0274	Bitewings - four radiographic images	0%	15	15	$0.00
D0230	Intraoral - periapical each additional radiographic image	0%	180	94	$0.00

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.