Dental
Jacobs, Stacey
Jacobs, Stacey was paid $30K by Medicaid between Dec 2020 and Oct 2024, across 8 billing codes. Its largest line is D0120, dental checkup, returning patient — 47% of everything it billed.
33Billing provider infoJACOBS, STACEY
CASTROVILLE, TX 78009
CASTROVILLE, TX 78009
33aNPI1831239847assigned 02/07/2007
33bProvider typeGeneral Practice Dentistry
28Total paid$30K
24GClaims1,801
24DCodes billed8
24AFirst – last monthDec 2020 – Oct 2024
Compared with peers
Next to other General Practice Dentistry providers in Texas
Rank by total paid#1,528 of 2,774
Median peer was paid$43K
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 | |
|---|---|---|---|
| 2020 | 12 | $0.00 | |
| 2021 | 639 | $11K | |
| 2022 | 535 | $10K | |
| 2023 | 342 | $5K | |
| 2024incomplete | 273 | $4K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 47% | 494 | 494 | $14K |
| D1120 | Dental cleaning, childProphylaxis - child | 25% | 208 | 208 | $8K |
| D1206 | Topical application of fluoride varnish | 10% | 212 | 212 | $3K |
| D0274 | Bitewings - four radiographic images | 9.2% | 80 | 80 | $3K |
| D0272 | Bitewings - two radiographic images | 5.4% | 70 | 70 | $2K |
| D1110 | Prophylaxis - adult | 2.7% | 15 | 15 | $823.20 |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 15 | 15 | $220.50 |
| D0603 | 0% | 707 | 707 | $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.