Dental
Moon, Jake
Moon, Jake was paid $92K by Medicaid between Jan 2018 and Apr 2019, across 15 billing codes. Its largest line is D1110, Prophylaxis - adult — 22% of everything it billed.
33Billing provider infoMOON, JAKE
AUBREY, TX 76227
AUBREY, TX 76227
33aNPI1669722658assigned 09/17/2012
33bProvider typeGeneral Practice Dentistry
28Total paid$92K
24GClaims3,408
24DCodes billed15
24AFirst – last monthJan 2018 – Apr 2019
Compared with peers
Next to other General Practice Dentistry providers in Texas
Rank by total paid#1,110 of 2,774
Median peer was paid$43K
This provider vs. median2.2×
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 | 2,828 | $78K | |
| 2019 | 580 | $14K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 22% | 444 | 444 | $20K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 20% | 599 | 599 | $18K |
| D1206 | Topical application of fluoride varnish | 9.3% | 275 | 275 | $9K |
| D1120 | Dental cleaning, childProphylaxis - child | 8.8% | 180 | 180 | $8K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 8.7% | 114 | 74 | $8K |
| D2751 | Crown - porcelain fused to predominantly base metal | 8.4% | 14 | 12 | $8K |
| D0140 | Limited oral evaluation - problem focused | 3.8% | 292 | 285 | $4K |
| D0274 | Bitewings - four radiographic images | 3.5% | 270 | 270 | $3K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 2.9% | 49 | 26 | $3K |
| D0210 | Intraoral - complete series of radiographic images | 2.8% | 57 | 57 | $3K |
| D0220 | Intraoral - periapical first radiographic image | 2.8% | 509 | 497 | $3K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.6% | 54 | 54 | $2K |
3 more codes
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.