Wallace, Dustin

Wallace, Dustin was paid $48K by Medicaid between Jan 2018 and Nov 2020, across 9 billing codes. Its largest line is D0120, dental checkup, returning patient — 29% of everything it billed.

33Billing provider infoWALLACE, DUSTIN
PINE BLUFF, AR 71603

33aNPI1770932808assigned 06/09/2016

33bProvider typeGeneral Practice Dentistry

28Total paid$48K

24GClaims1,438

24DCodes billed9

24AFirst – last monthJan 2018 – Nov 2020

Compared with peers

Next to other General Practice Dentistry providers in Arkansas

Rank by total paid#179 of 401

Median peer was paid$36K

This provider vs. median1.3×

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	948	$33K
2019	407	$12K
2020	83	$2K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	29%	550	447	$14K
D1110	Prophylaxis - adult	25%	277	211	$12K
D0330	Panoramic radiographic image	13%	132	83	$6K
D0210	Intraoral - complete series of radiographic images	11%	61	43	$5K
D1120	Dental cleaning, childProphylaxis - child	8.8%	121	83	$4K
D1206	Topical application of fluoride varnish	6.3%	156	111	$3K
D0272	Bitewings - two radiographic images	3.8%	82	73	$2K
D0150	Comprehensive oral evaluation - new or established patient	2.8%	43	39	$1K
D0220	Intraoral - periapical first radiographic image	<1%	16	16	$270.75

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.