NPI: 1376588848 · SALEM, IL 62881 · Dentist · NPI assigned 06/18/2006
Authorized official MCCULLEY, LARRY controls 20+ related entities in our dataset. Read more
| Authorized Official | MCCULLEY, LARRY (CHIEF OPERATING OFFICER) |
| NPI Enumeration Date | 06/18/2006 |
Other providers sharing the same authorized official: MCCULLEY, LARRY
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 14,820 | $889K |
| 2019 | 25,189 | $883K |
| 2020 | 18,229 | $1.19M |
| 2021 | 15,549 | $1.13M |
| 2022 | 17,794 | $1.29M |
| 2023 | 16,769 | $1.25M |
| 2024 | 27,376 | $1.24M |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | 62,606 | 47,121 | $7.88M |
| 90688 | 387 | 260 | $584.40 | |
| 90670 | 384 | 344 | $577.51 | |
| 90734 | 301 | 244 | $394.85 | |
| 90715 | 265 | 210 | $197.55 | |
| 83036 | Hemoglobin; glycosylated (A1C) | 970 | 859 | $63.00 |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 27 | 15 | $58.86 |
| 81003 | 285 | 257 | $19.62 | |
| 90686 | 182 | 136 | $6.40 | |
| 81025 | 46 | 28 | $2.58 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 7,557 | 6,020 | $0.00 |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 1,068 | 917 | $0.00 |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 1,455 | 1,205 | $0.00 |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 968 | 766 | $0.00 |
| 3078F | 2,700 | 2,505 | $0.00 | |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | 282 | 249 | $0.00 |
| 99203 | Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 484 | 450 | $0.00 |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 374 | 350 | $0.00 |
| 80305 | 402 | 377 | $0.00 | |
| 99307 | 40 | 37 | $0.00 | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 1,120 | 937 | $0.00 |
| 3725F | 1,075 | 1,012 | $0.00 | |
| 90648 | 13 | 12 | $0.00 | |
| 90633 | 193 | 182 | $0.00 | |
| 96160 | 65 | 64 | $0.00 | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 18 | 18 | $0.00 |
| 3077F | 288 | 270 | $0.00 | |
| 90710 | 112 | 83 | $0.00 | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 29 | 28 | $0.00 |
| 90791 | Psychiatric diagnostic evaluation | 53 | 53 | $0.00 |
| 90658 | 20 | 20 | $0.00 | |
| 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 5,780 | 4,776 | $0.00 |
| 3080F | 196 | 183 | $0.00 | |
| 90677 | 127 | 126 | $0.00 | |
| 99384 | 15 | 15 | $0.00 | |
| 3079F | 839 | 787 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 152 | 142 | $0.00 |
| 87428 | 110 | 108 | $0.00 | |
| 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 29,980 | 23,098 | $0.00 |
| 36415 | Collection of venous blood by venipuncture | 695 | 649 | $0.00 |
| 3074F | 3,010 | 2,780 | $0.00 | |
| 90697 | 24 | 24 | $0.00 | |
| 90792 | Psychiatric diagnostic evaluation with medical services | 634 | 511 | $0.00 |
| S5190 | Wellness assessment, performed by non-physician | 397 | 345 | $0.00 |
| 96127 | 2,910 | 2,368 | $0.00 | |
| 3075F | 456 | 429 | $0.00 | |
| 90651 | 228 | 181 | $0.00 | |
| 1036F | 2,116 | 1,923 | $0.00 | |
| 3008F | 4,032 | 3,639 | $0.00 | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | 83 | 83 | $0.00 |
| G0467 | Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit | 65 | 61 | $0.00 |
| 90696 | 95 | 71 | $0.00 | |
| 90698 | 13 | 13 | $0.00 |