Hudson, Lacy

Hudson, Lacy was paid $165K by Medicaid between Apr 2023 and Dec 2024, across 18 billing codes. Its largest line is D0210, Intraoral - complete series of radiographic images — 15% of everything it billed.

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
2023	2,030	$71K
2024incomplete	3,287	$94K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0210	Intraoral - complete series of radiographic images	15%	522	512	$25K
D1208	Topical application of fluoride, excluding varnish	12%	1,042	1,022	$20K
D1120	Dental cleaning, childProphylaxis - child	11%	605	597	$19K
D1110	Prophylaxis - adult	11%	416	413	$18K
D7140	Extraction, erupted tooth or exposed root	11%	258	119	$18K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	10.0%	661	652	$16K
D0150	Comprehensive oral evaluation - new or established patient	7.6%	435	431	$13K
D9110		5.6%	193	190	$9K
D1351	Sealant - per tooth	5.1%	478	107	$8K
D0220	Intraoral - periapical first radiographic image	2.6%	349	340	$4K
D2391	Resin-based composite - one surface, posterior, primary or permanent	2.6%	75	58	$4K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	2.2%	49	41	$4K

6 more codes

D0330	Panoramic radiographic image	2.0%	73	$3K
D0272	Bitewings - two radiographic images	<1%	63	$1K
D0140	Limited oral evaluation - problem focused	<1%	42	$947.58
D0274	Bitewings - four radiographic images	<1%	24	$595.33
D0230	Intraoral - periapical each additional radiographic image	<1%	16	$101.38
D1330		0%	16	$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.