Dental
Solomon, Stacy
Solomon, Stacy was paid $17K by Medicaid between Jan 2018 and Mar 2021, across 6 billing codes. Its largest line is D0120, dental checkup, returning patient — 41% of everything it billed.
33Billing provider infoSOLOMON, STACY
BROKEN BOW, NE 68822
BROKEN BOW, NE 68822
33aNPI1720158280assigned 11/09/2006
33bProvider typeGeneral Practice Dentistry
28Total paid$17K
24GClaims812
24DCodes billed6
24AFirst – last monthJan 2018 – Mar 2021
Compared with peers
Next to other General Practice Dentistry providers in Nebraska
Rank by total paid#106 of 201
Median peer was paid$21K
This provider vs. median0.8×
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 | 389 | $9K | |
| 2019 | 283 | $6K | |
| 2020 | 127 | $2K | |
| 2021 | 13 | $251.79 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 41% | 324 | 324 | $7K |
| D1120 | Dental cleaning, childProphylaxis - child | 26% | 171 | 171 | $4K |
| D1208 | Topical application of fluoride, excluding varnish | 23% | 209 | 192 | $4K |
| D1110 | Prophylaxis - adult | 4.7% | 25 | 25 | $792.00 |
| D1999 | 3.4% | 59 | 54 | $570.00 | |
| D0274 | Bitewings - four radiographic images | 2.5% | 24 | 24 | $422.18 |
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.