Pendergrass, Barry

Pendergrass, Barry was paid $26K by Medicaid between Mar 2018 and Nov 2024, across 8 billing codes. Its largest line is D1110, Prophylaxis - adult — 51% of everything it billed.

33Billing provider infoPENDERGRASS, BARRY
CENTERVILLE, TN 37033

33aNPI1851474779assigned 10/23/2006

33bProvider typeGeneral Practice Dentistry

28Total paid$26K

24GClaims944

24DCodes billed8

24AFirst – last monthMar 2018 – Nov 2024

Compared with peers

Next to other General Practice Dentistry providers in Tennessee

Rank by total paid#249 of 336

Median peer was paid$123K

This provider vs. median0.2×

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	88	$3K
2019	13	$564.72
2022	12	$521.28
2023	468	$14K
2024incomplete	363	$8K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1110	Prophylaxis - adult	51%	322	316	$13K
D0150	Comprehensive oral evaluation - new or established patient	16%	147	143	$4K
D0330	Panoramic radiographic image	14%	76	75	$4K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	10%	125	121	$3K
D1206	Topical application of fluoride varnish	4.6%	57	57	$1K
D0272	Bitewings - two radiographic images	2.9%	53	52	$760.68
D0220	Intraoral - periapical first radiographic image	<1%	16	13	$128.10
D0431		0%	148	143	$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.