SAGADRACA, TOMMY JOHN
NPI: 1215387113
· MACHESNEY PARK, IL 61115
· General Practice Dentistry
· NPI assigned 06/21/2016
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
71 |
$2K |
| 2023 |
60 |
$2K |
| 2024 |
67 |
$2K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
120 |
119 |
$3K |
| D1110 |
Prophylaxis - adult |
40 |
40 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
12 |
12 |
$298.08 |
| D0220 |
Intraoral - periapical first radiographic image |
26 |
26 |
$171.86 |