Short, Jacksie

Short, Jacksie was paid $27K by Medicaid between Jan 2018 and Jun 2018, across 6 billing codes. Its largest line is D1206, Topical application of fluoride varnish — 84% of everything it billed.

33Billing provider infoSHORT, JACKSIE
JOPLIN, MO 64804

33aNPI1790207546assigned 07/13/2017

33bProvider typeGeneral Practice Dentistry

28Total paid$27K

24GClaims373

24DCodes billed6

24AFirst – last monthJan 2018 – Jun 2018

Compared with peers

Next to other General Practice Dentistry providers in Missouri

Rank by total paid#178 of 260

Median peer was paid$78K

This provider vs. median0.3×

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	373	$27K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1206	Topical application of fluoride varnish	84%	255	254	$23K
D1110	Prophylaxis - adult	5.4%	16	16	$1K
D0330	Panoramic radiographic image	4.1%	14	14	$1K
D1120	Dental cleaning, childProphylaxis - child	3.8%	13	13	$1K
D1351	Sealant - per tooth	2.1%	63	14	$568.00
D0220	Intraoral - periapical first radiographic image	<1%	12	12	$72.00

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.