Dental
Archie, Thaddous
Archie, Thaddous was paid $847K by Medicaid between Jan 2018 and Nov 2024, across 26 billing codes. Its largest line is D0120, dental checkup, returning patient — 18% of everything it billed.
33Billing provider infoARCHIE, THADDOUS
ELK GROVE, CA 95758
ELK GROVE, CA 95758
33aNPI1992864011assigned 12/06/2006
33bProvider typeGeneral Practice Dentistry
28Total paid$847K
24GClaims36,571
24DCodes billed26
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other General Practice Dentistry providers in California
Rank by total paid#639 of 2,668
Median peer was paid$173K
This provider vs. median4.9×
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 | 5,299 | $86K | |
| 2019 | 4,487 | $71K | |
| 2020 | 4,402 | $110K | |
| 2021 | 5,383 | $151K | |
| 2022 | 6,624 | $160K | |
| 2023 | 5,980 | $150K | |
| 2024incomplete | 4,396 | $119K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 18% | 4,231 | 4,166 | $156K |
| D1110 | Prophylaxis - adult | 18% | 2,122 | 2,089 | $152K |
| D1208 | Topical application of fluoride, excluding varnish | 12% | 4,511 | 4,451 | $100K |
| D1120 | Dental cleaning, childProphylaxis - child | 11% | 2,387 | 2,355 | $91K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 8.7% | 1,355 | 848 | $73K |
| D0220 | Intraoral - periapical first radiographic image | 5.3% | 4,017 | 3,910 | $45K |
| D0230 | Intraoral - periapical each additional radiographic image | 4.4% | 9,874 | 3,378 | $37K |
| D0274 | Bitewings - four radiographic images | 4.3% | 1,794 | 1,776 | $36K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 3.4% | 661 | 408 | $29K |
| D0150 | Comprehensive oral evaluation - new or established patient | 3.4% | 572 | 563 | $28K |
| D4910 | 2.5% | 170 | 170 | $22K | |
| D0210 | Intraoral - complete series of radiographic images | 2.2% | 420 | 413 | $18K |
14 more codes
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 2.2% | 271 | $18K |
| D9430 | 1.7% | 544 | $15K | |
| D0272 | Bitewings - two radiographic images | 1.4% | 985 | $12K |
| D1999 | 1.1% | 949 | $9K | |
| D0170 | <1% | 37 | $2K | |
| D0999 | Unspecified diagnostic procedure, by report | <1% | 27 | $2K |
| D0160 | <1% | 37 | $1K | |
| D9999 | Unspecified adjunctive procedure, by report | <1% | 13 | $1K |
| D1351 | Sealant - per tooth | <1% | 49 | $704.00 |
| D0602 | <1% | 162 | $155.00 | |
| D0603 | <1% | 126 | $99.00 | |
| D0601 | <1% | 12 | $12.00 | |
| D1330 | 0% | 1,008 | $0.00 | |
| D9993 | 0% | 237 | $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.