Dental
Clemens, Dawn
Clemens, Dawn was paid $416K by Medicaid between May 2019 and Jun 2021, across 21 billing codes. Its largest line is D9999, Unspecified adjunctive procedure, by report — 99% of everything it billed.
33Billing provider infoCLEMENS, DAWN
NORTH TONAWANDA, NY 14120
NORTH TONAWANDA, NY 14120
33aNPI1932207651assigned 09/20/2006
33bProvider typeGeneral Practice Dentistry
28Total paid$416K
24GClaims8,765
24DCodes billed21
24AFirst – last monthMay 2019 – Jun 2021
Compared with peers
Next to other General Practice Dentistry providers in New York
Rank by total paid#363 of 2,184
Median peer was paid$54K
This provider vs. median7.8×
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 | |
|---|---|---|---|
| 2019 | 937 | $52K | |
| 2020 | 4,760 | $200K | |
| 2021 | 3,068 | $165K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D9999 | Unspecified adjunctive procedure, by report | 99% | 2,979 | 2,528 | $413K |
| D1110 | Prophylaxis - adult | <1% | 951 | 951 | $812.00 |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | <1% | 1,182 | 1,182 | $496.00 |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | <1% | 290 | 249 | $337.01 |
| D0330 | Panoramic radiographic image | <1% | 431 | 431 | $333.00 |
| D0274 | Bitewings - four radiographic images | <1% | 654 | 654 | $238.01 |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 106 | 92 | $180.00 |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 183 | 183 | $176.00 |
| D0140 | Limited oral evaluation - problem focused | <1% | 231 | 231 | $168.00 |
| D0220 | Intraoral - periapical first radiographic image | <1% | 321 | 317 | $133.01 |
| D1120 | Dental cleaning, childProphylaxis - child | <1% | 203 | 203 | $43.00 |
| D0272 | Bitewings - two radiographic images | <1% | 36 | 36 | $17.00 |
9 more codes
| D1208 | Topical application of fluoride, excluding varnish | <1% | 130 | $0.01 |
| D1999 | 0% | 870 | $0.00 | |
| D4910 | 0% | 13 | $0.00 | |
| D0603 | 0% | 61 | $0.00 | |
| D7140 | Extraction, erupted tooth or exposed root | 0% | 19 | $0.00 |
| D0602 | 0% | 52 | $0.00 | |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 0% | 15 | $0.00 |
| D1206 | Topical application of fluoride varnish | 0% | 25 | $0.00 |
| D0601 | 0% | 13 | $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.