Montoya, Jose

Montoya, Jose was paid $7K by Medicaid between Jun 2022 and Oct 2023, across 5 billing codes. Its largest line is D1110, Prophylaxis - adult — 71% of everything it billed.

33Billing provider infoMONTOYA, JOSE
BARTLETT, TN 38134

33aNPI1942372446assigned 11/14/2006

33bProvider typeGeneral Practice Dentistry

28Total paid$7K

24GClaims323

24DCodes billed5

24AFirst – last monthJun 2022 – Oct 2023

Compared with peers

Next to other General Practice Dentistry providers in Tennessee

Rank by total paid#292 of 336

Median peer was paid$123K

This provider vs. median0.1×

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	64	$1K
2023	259	$6K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1110	Prophylaxis - adult	71%	97	97	$5K
D1208	Topical application of fluoride, excluding varnish	16%	83	83	$1K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	11%	29	29	$807.80
D0220	Intraoral - periapical first radiographic image	2.1%	12	12	$150.72
D0603		0%	102	97	$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.