Dental
Richardson, Jacquelyn
Richardson, Jacquelyn was paid $118K by Medicaid between Feb 2024 and Dec 2024, across 7 billing codes. Its largest line is D1351, Sealant - per tooth — 37% of everything it billed.
33Billing provider infoRICHARDSON, JACQUELYN
MOLINE, IL 61265
MOLINE, IL 61265
33aNPI1780853366assigned 02/27/2008
33bProvider typeDentist
28Total paid$118K
24GClaims3,173
24DCodes billed7
24AFirst – last monthFeb 2024 – Dec 2024
Compared with peers
Next to other Dentist providers in Illinois
Rank by total paid#601 of 1,099
Median peer was paid$160K
This provider vs. median0.7×
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 | |
|---|---|---|---|
| 2024incomplete | 3,173 | $118K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1351 | Sealant - per tooth | 37% | 649 | 391 | $44K |
| D1120 | Dental cleaning, childProphylaxis - child | 27% | 744 | 744 | $32K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 19% | 769 | 769 | $23K |
| D1206 | Topical application of fluoride varnish | 17% | 733 | 733 | $20K |
| D0603 | 0% | 62 | 62 | $0.00 | |
| D0602 | 0% | 118 | 118 | $0.00 | |
| D0601 | 0% | 98 | 98 | $0.00 |
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.