Moudy, Forrest

Moudy, Forrest was paid $22K by Medicaid between Jan 2018 and Jan 2019, across 5 billing codes. Its largest line is D1110, Prophylaxis - adult — 24% of everything it billed.

33Billing provider infoMOUDY, FORREST
DANVILLE, AR 72833

33aNPI1750707097assigned 03/11/2014

33bProvider typeGeneral Practice Dentistry

28Total paid$22K

24GClaims803

24DCodes billed5

24AFirst – last monthJan 2018 – Jan 2019

Compared with peers

Next to other General Practice Dentistry providers in Arkansas

Rank by total paid#235 of 401

Median peer was paid$36K

This provider vs. median0.6×

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	$21K
2019	52	$1K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1110	Prophylaxis - adult	24%	117	65	$5K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	23%	201	118	$5K
D0272	Bitewings - two radiographic images	19%	186	122	$4K
D0140	Limited oral evaluation - problem focused	18%	134	84	$4K
D1208	Topical application of fluoride, excluding varnish	14%	165	105	$3K

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.