NPI: 1083121537 · QUINCY, IL 62301 · Primary Care Clinic/Center · NPI assigned 01/05/2018
Authorized official WESLEY, IRIS controls 19+ related entities in our dataset. Read more
| Authorized Official | WESLEY, IRIS (CEO) |
| Parent Organization | BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY |
| NPI Enumeration Date | 01/05/2018 |
Other providers sharing the same authorized official: WESLEY, IRIS
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 838 | $25K |
| 2019 | 534 | $21K |
| 2020 | 110 | $9K |
| 2021 | 8,684 | $178K |
| 2022 | 399 | $29K |
| 2023 | 8,309 | $286K |
| 2024 | 24,112 | $857K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0999 | Unspecified diagnostic procedure, by report | 12,008 | 11,369 | $1.25M |
| D0120 | Periodic oral evaluation - established patient | 4,797 | 4,762 | $87K |
| D1206 | Topical application of fluoride varnish | 5,804 | 5,761 | $15K |
| D0220 | Intraoral - periapical first radiographic image | 1,963 | 1,925 | $13K |
| D0140 | Limited oral evaluation - problem focused | 975 | 954 | $12K |
| D0150 | Comprehensive oral evaluation - new or established patient | 870 | 870 | $10K |
| D1120 | Prophylaxis - child | 5,518 | 5,490 | $9K |
| D0330 | Panoramic radiographic image | 1,259 | 1,253 | $4K |
| D7140 | Extraction, erupted tooth or exposed root | 461 | 415 | $2K |
| D0274 | Bitewings - four radiographic images | 1,525 | 1,512 | $2K |
| D0272 | Bitewings - two radiographic images | 1,559 | 1,551 | $1K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 628 | 608 | $590.10 |
| D0230 | Intraoral - periapical each additional radiographic image | 1,319 | 1,195 | $467.00 |
| D0603 | 1,191 | 1,188 | $0.00 | |
| D0602 | 732 | 726 | $0.00 | |
| D0601 | 980 | 979 | $0.00 | |
| D1351 | Sealant - per tooth | 253 | 224 | $0.00 |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 290 | 277 | $0.00 |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 72 | 70 | $0.00 |
| D2331 | 26 | 26 | $0.00 | |
| D2330 | 25 | 25 | $0.00 | |
| D2335 | 12 | 12 | $0.00 | |
| D1354 | 348 | 310 | $0.00 | |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 328 | 309 | $0.00 |
| D0270 | 29 | 28 | $0.00 | |
| D1110 | Prophylaxis - adult | 14 | 14 | $0.00 |