Jackson, David

Jackson, David was paid $9K by Medicaid between Jul 2018 and Aug 2019, across 7 billing codes. Its largest line is D0150, Comprehensive oral evaluation - new or established patient — 25% of everything it billed.

33Billing provider infoJACKSON, DAVID
HANNIBAL, MO 63401

33aNPI1699812644assigned 01/31/2007

33bProvider typeGeneral Practice Dentistry

28Total paid$9K

24GClaims345

24DCodes billed7

24AFirst – last monthJul 2018 – Aug 2019

Compared with peers

Next to other General Practice Dentistry providers in Missouri

Rank by total paid#208 of 260

Median peer was paid$78K

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	333	$9K
2019	12	$322.92

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0150	Comprehensive oral evaluation - new or established patient	25%	50	44	$2K
D1120	Dental cleaning, childProphylaxis - child	16%	62	56	$1K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	14%	47	41	$1K
D1206	Topical application of fluoride varnish	14%	82	74	$1K
D2391	Resin-based composite - one surface, posterior, primary or permanent	12%	24	12	$1K
D0210	Intraoral - complete series of radiographic images	10%	29	27	$925.00
D0272	Bitewings - two radiographic images	9.1%	51	47	$816.00

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.