1821210915

1821210915 was paid $17K by Medicaid between May 2018 and Jul 2021, across 8 billing codes. Its largest line is D0120, dental checkup, returning patient — 23% of everything it billed.

33Billing provider info1821210915

33aNPI1821210915

33bProvider type—

28Total paid$17K

24GClaims655

24DCodes billed8

24AFirst – last monthMay 2018 – Jul 2021

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	77	$717.00
2019	39	$2K
2020	526	$14K
2021	13	$156.00

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	23%	117	117	$4K
D0220	Intraoral - periapical first radiographic image	20%	282	256	$3K
D5750		16%	14	14	$3K
D1110	Prophylaxis - adult	13%	24	24	$2K
D9110		8.3%	22	19	$1K
D2150	Silver amalgam - two surfaces, primary or permanent	7.6%	20	12	$1K
D0230	Intraoral - periapical each additional radiographic image	7.6%	158	103	$1K
D2920		4.5%	18	15	$756.00

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.