Dental
Gudmestad, Tom
Gudmestad, Tom was paid $9K by Medicaid between Feb 2018 and Jun 2022, across 3 billing codes. Its largest line is D1110, Prophylaxis - adult — 100% of everything it billed.
33Billing provider infoGUDMESTAD, TOM
WEISER, ID 83672
WEISER, ID 83672
33aNPI1851308050assigned 08/01/2006
33bProvider typeGeneral Practice Dentistry
28Total paid$9K
24GClaims331
24DCodes billed3
24AFirst – last monthFeb 2018 – Jun 2022
Compared with peers
Next to other General Practice Dentistry providers in Idaho
Rank by total paid#110 of 173
Median peer was paid$22K
This provider vs. median0.4×
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 | 141 | $3K | |
| 2019 | 28 | $984.58 | |
| 2020 | 93 | $2K | |
| 2021 | 43 | $1K | |
| 2022 | 26 | $2K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 100% | 144 | 144 | $9K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | <1% | 130 | 130 | $19.24 |
| D1208 | Topical application of fluoride, excluding varnish | 0% | 57 | 57 | $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.