Clinic
Modelevsky DDS PA
Modelevsky DDS PA was paid $963K by Medicaid between Mar 2018 and Jul 2023, across 4 billing codes. Its largest line is D7240, Removal of impacted tooth - completely bony — 75% of everything it billed.
33Billing provider infoMODELEVSKY DDS PA
JONESBORO, AR 72401
JONESBORO, AR 72401
33aNPI1922267657assigned 06/06/2008
33bProvider typeOral and Maxillofacial Surgery Clinic/Center
28Total paid$963K
24GClaims5,703
24DCodes billed4
24AFirst – last monthMar 2018 – Jul 2023
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 | 103 | $191.90 | |
| 2020 | 888 | $151K | |
| 2021 | 2,144 | $368K | |
| 2022 | 1,336 | $225K | |
| 2023 | 1,232 | $219K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D7240 | Removal of impacted tooth - completely bony | 75% | 2,827 | 851 | $718K |
| D9223 | Deep sedation/general anesthesia - each subsequent 15 minute increment | 15% | 1,841 | 1,065 | $146K |
| D9222 | 9.2% | 985 | 969 | $88K | |
| D7230 | 1.1% | 50 | 30 | $10K |
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.
From NPPES
Who's on the registration
Authorized officialMODELEVSKY, TERI (OFFICE MANAGER)