Dental
Clark, Kelly
Clark, Kelly was paid $163K by Medicaid between Feb 2018 and Dec 2024, across 11 billing codes. Its largest line is D1120, dental cleaning, child — 42% of everything it billed.
33Billing provider infoCLARK, KELLY
DECATUR, IL 62521
DECATUR, IL 62521
33aNPI1942379458assigned 11/07/2006
33bProvider typeGeneral Practice Dentistry
28Total paid$163K
24GClaims5,426
24DCodes billed11
24AFirst – last monthFeb 2018 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in Illinois
Rank by total paid#448 of 1,017
Median peer was paid$123K
This provider vs. median1.3×
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 | 217 | $7K | |
| 2019 | 471 | $14K | |
| 2020 | 627 | $19K | |
| 2021 | 1,429 | $42K | |
| 2022 | 916 | $27K | |
| 2023 | 975 | $29K | |
| 2024incomplete | 791 | $25K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 42% | 1,694 | 1,623 | $68K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 30% | 1,802 | 1,724 | $50K |
| D1206 | Topical application of fluoride varnish | 12% | 904 | 879 | $19K |
| D7140 | Extraction, erupted tooth or exposed root | 7.0% | 125 | 91 | $11K |
| D0274 | Bitewings - four radiographic images | 3.7% | 342 | 332 | $6K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.7% | 213 | 206 | $4K |
| D1110 | Prophylaxis - adult | 1.3% | 58 | 58 | $2K |
| D0272 | Bitewings - two radiographic images | <1% | 86 | 83 | $870.17 |
| D0220 | Intraoral - periapical first radiographic image | <1% | 120 | 111 | $694.59 |
| D0330 | Panoramic radiographic image | <1% | 26 | 25 | $613.84 |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 56 | 51 | $288.80 |
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.