Dental
Sandidge, Marissa
Sandidge, Marissa was paid $1.00M by Medicaid between Jul 2020 and Dec 2024, across 24 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 17% of everything it billed.
33Billing provider infoSANDIDGE, MARISSA
COOKEVILLE, TN 38501
COOKEVILLE, TN 38501
33aNPI1992194195assigned 01/12/2015
33bProvider typeDentist
28Total paid$1.00M
24GClaims34,679
24DCodes billed24
24AFirst – last monthJul 2020 – Dec 2024
Compared with peers
Next to other Dentist providers in Tennessee
Rank by total paid#26 of 242
Median peer was paid$164K
This provider vs. median6.1×
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 | |
|---|---|---|---|
| 2020 | 374 | $7K | |
| 2021 | 5,558 | $183K | |
| 2022 | 10,903 | $348K | |
| 2023 | 9,579 | $255K | |
| 2024incomplete | 8,265 | $211K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 17% | 1,549 | 534 | $172K |
| D1120 | Dental cleaning, childProphylaxis - child | 16% | 4,677 | 4,655 | $160K |
| D1206 | Topical application of fluoride varnish | 11% | 4,931 | 4,910 | $106K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 9.4% | 1,275 | 621 | $94K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 8.1% | 3,256 | 3,247 | $81K |
| D0230 | Intraoral - periapical each additional radiographic image | 6.6% | 7,624 | 2,256 | $66K |
| D7140 | Extraction, erupted tooth or exposed root | 6.5% | 1,045 | 473 | $65K |
| D0150 | Comprehensive oral evaluation - new or established patient | 6.4% | 2,218 | 2,193 | $64K |
| D0220 | Intraoral - periapical first radiographic image | 3.9% | 3,230 | 3,152 | $39K |
| D0330 | Panoramic radiographic image | 3.5% | 854 | 847 | $35K |
| D1351 | Sealant - per tooth | 3.4% | 1,065 | 382 | $34K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 2.8% | 993 | 909 | $28K |
12 more codes
| D0272 | Bitewings - two radiographic images | 1.2% | 727 | $12K |
| D0274 | Bitewings - four radiographic images | <1% | 384 | $10K |
| D9248 | <1% | 113 | $9K | |
| D1110 | Prophylaxis - adult | <1% | 166 | $6K |
| D2929 | <1% | 53 | $6K | |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | <1% | 66 | $5K |
| D1510 | <1% | 21 | $3K | |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 48 | $3K |
| D0140 | Limited oral evaluation - problem focused | <1% | 80 | $2K |
| D2331 | <1% | 19 | $1K | |
| D1354 | <1% | 158 | $1K | |
| D9420 | <1% | 127 | $75.00 |
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.