Kaczkowski, Stanley

Kaczkowski, Stanley was paid $14K by Medicaid between Feb 2018 and Jun 2022, across 8 billing codes. Its largest line is D0120, dental checkup, returning patient — 40% of everything it billed.

33Billing provider infoKACZKOWSKI, STANLEY
CROSS LANES, WV 25313

33aNPI1962502831assigned 09/22/2006

33bProvider typeGeneral Practice Dentistry

28Total paid$14K

24GClaims560

24DCodes billed8

24AFirst – last monthFeb 2018 – Jun 2022

Compared with peers

Next to other General Practice Dentistry providers in West Virginia

Rank by total paid#121 of 193

Median peer was paid$44K

This provider vs. median0.3×

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	55	$2K
2019	145	$2K
2020	117	$2K
2021	163	$6K
2022	80	$3K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	40%	234	209	$6K
D1110	Prophylaxis - adult	33%	101	100	$5K
D0330	Panoramic radiographic image	7.3%	45	42	$1K
D0140	Limited oral evaluation - problem focused	7.2%	90	86	$1K
D1208	Topical application of fluoride, excluding varnish	5.0%	40	36	$726.00
D1120	Dental cleaning, childProphylaxis - child	3.4%	16	13	$484.00
D0274	Bitewings - four radiographic images	3.1%	12	12	$452.00
D7140	Extraction, erupted tooth or exposed root	<1%	22	13	$130.00

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.