Dental
Tietgen, Ashley
Tietgen, Ashley was paid $4K by Medicaid between Mar 2022 and Jun 2022, across 7 billing codes. Its largest line is D1120, dental cleaning, child — 34% of everything it billed.
33Billing provider infoTIETGEN, ASHLEY
BELLEVUE, NE 68005
BELLEVUE, NE 68005
33aNPI1932588969assigned 05/22/2015
33bProvider typePediatric Dentist
28Total paid$4K
24GClaims260
24DCodes billed7
24AFirst – last monthMar 2022 – Jun 2022
Compared with peers
Next to other Pediatric Dentist providers in Nebraska
Rank by total paid#49 of 52
Median peer was paid$292K
This provider vs. median0.0×
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 | |
|---|---|---|---|
| 2022 | 260 | $4K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 34% | 62 | 62 | $2K |
| D1206 | Topical application of fluoride varnish | 27% | 77 | 77 | $1K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 14% | 31 | 30 | $618.20 |
| D0150 | Comprehensive oral evaluation - new or established patient | 8.8% | 18 | 18 | $395.52 |
| D0272 | Bitewings - two radiographic images | 7.7% | 26 | 26 | $344.22 |
| D0230 | Intraoral - periapical each additional radiographic image | 4.9% | 28 | 15 | $220.97 |
| D0220 | Intraoral - periapical first radiographic image | 4.4% | 18 | 18 | $199.40 |
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.