NPI: 1487719860 · EAST ALTON, IL 62024 · Dentist · NPI assigned 12/26/2006
Authorized official MCCULLEY, LARRY controls 20+ related entities in our dataset. Read more
| Authorized Official | MCCULLEY, LARRY (CHIEF OPERATING OFFICER) |
| NPI Enumeration Date | 12/26/2006 |
Other providers sharing the same authorized official: MCCULLEY, LARRY
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 53,342 | $2.23M |
| 2019 | 93,197 | $2.81M |
| 2020 | 52,443 | $2.68M |
| 2021 | 68,759 | $3.18M |
| 2022 | 42,083 | $2.42M |
| 2023 | 55,102 | $2.94M |
| 2024 | 94,753 | $4.12M |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | 114,604 | 79,393 | $14.95M |
| D0999 | Unspecified diagnostic procedure, by report | 41,984 | 38,786 | $4.86M |
| D1120 | Prophylaxis - child | 25,358 | 24,987 | $269K |
| D0120 | Periodic oral evaluation - established patient | 24,815 | 24,379 | $96K |
| D0150 | Comprehensive oral evaluation - new or established patient | 4,283 | 4,217 | $61K |
| D0140 | Limited oral evaluation - problem focused | 1,535 | 1,483 | $26K |
| D7140 | Extraction, erupted tooth or exposed root | 2,598 | 2,171 | $23K |
| T1040 | Medicaid certified community behavioral health clinic services, per diem | 284 | 164 | $22K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 2,953 | 2,443 | $18K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 4,097 | 3,308 | $17K |
| D0274 | Bitewings - four radiographic images | 2,414 | 2,389 | $11K |
| D2140 | 738 | 606 | $5K | |
| D2940 | 191 | 170 | $5K | |
| 90651 | 1,926 | 1,544 | $4K | |
| 90734 | 2,046 | 1,640 | $3K | |
| D2330 | 711 | 582 | $2K | |
| 90670 | 3,259 | 2,778 | $2K | |
| D1354 | 942 | 757 | $1K | |
| 90620 | 727 | 584 | $1K | |
| 90688 | 1,017 | 755 | $1K | |
| 90710 | 948 | 744 | $1K | |
| D0272 | Bitewings - two radiographic images | 11,221 | 11,030 | $711.36 |
| 90715 | 1,623 | 1,276 | $647.06 | |
| D1206 | Topical application of fluoride varnish | 26,542 | 26,093 | $606.43 |
| D0220 | Intraoral - periapical first radiographic image | 2,908 | 2,824 | $592.80 |
| 90680 | 2,262 | 1,984 | $497.34 | |
| 90723 | 2,639 | 2,305 | $459.55 | |
| D2331 | 55 | 51 | $396.57 | |
| 90716 | 654 | 522 | $372.46 | |
| 90686 | 3,522 | 2,834 | $360.63 | |
| 90633 | 2,385 | 2,008 | $350.64 | |
| 90707 | 676 | 541 | $290.08 | |
| 90696 | 835 | 675 | $255.85 | |
| 90647 | 2,823 | 2,396 | $242.47 | |
| 90700 | 665 | 526 | $124.80 | |
| 96127 | 8,721 | 6,892 | $73.20 | |
| 81025 | 909 | 607 | $10.32 | |
| S5190 | Wellness assessment, performed by non-physician | 569 | 544 | $9.81 |
| 81002 | 2,124 | 1,135 | $2.60 | |
| 90677 | 432 | 402 | $0.00 | |
| 3080F | 171 | 160 | $0.00 | |
| 99381 | 379 | 327 | $0.00 | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 5,661 | 4,508 | $0.00 |
| 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 13,491 | 11,124 | $0.00 |
| 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 54,839 | 41,916 | $0.00 |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 1,452 | 1,374 | $0.00 |
| 87428 | 726 | 709 | $0.00 | |
| 90697 | 126 | 112 | $0.00 | |
| 3079F | 879 | 823 | $0.00 | |
| 3074F | 5,088 | 4,578 | $0.00 | |
| D0230 | Intraoral - periapical each additional radiographic image | 562 | 501 | $0.00 |
| 3008F | 6,405 | 5,705 | $0.00 | |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 112 | 110 | $0.00 |
| D1351 | Sealant - per tooth | 3,933 | 1,877 | $0.00 |
| 90834 | Psychotherapy, 45 minutes with patient | 283 | 193 | $0.00 |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 12 | 12 | $0.00 |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 215 | 210 | $0.00 |
| 83036 | Hemoglobin; glycosylated (A1C) | 231 | 228 | $0.00 |
| 3075F | 365 | 347 | $0.00 | |
| 1036F | 4,056 | 3,627 | $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 | 42 | 40 | $0.00 |
| 99383 | 147 | 100 | $0.00 | |
| 90792 | Psychiatric diagnostic evaluation with medical services | 28 | 28 | $0.00 |
| 90656 | 285 | 254 | $0.00 | |
| 87807 | 70 | 68 | $0.00 | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | 52 | 52 | $0.00 |
| 99385 | 31 | 30 | $0.00 | |
| Q3014 | Telehealth originating site facility fee | 25 | 22 | $0.00 |
| D0603 | 19 | 19 | $0.00 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 4,285 | 3,624 | $0.00 |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 1,098 | 943 | $0.00 |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 4,878 | 3,949 | $0.00 |
| 3725F | 1,674 | 1,586 | $0.00 | |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 2,743 | 2,493 | $0.00 |
| 90832 | Psychotherapy, 30 minutes with patient | 7,584 | 3,092 | $0.00 |
| 0502F | 1,393 | 596 | $0.00 | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 270 | 243 | $0.00 |
| 99204 | Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 1,110 | 938 | $0.00 |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 5,102 | 4,182 | $0.00 |
| 3078F | 4,595 | 4,149 | $0.00 | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 4,571 | 3,723 | $0.00 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 4,022 | 3,242 | $0.00 |
| D0330 | Panoramic radiographic image | 411 | 411 | $0.00 |
| 90791 | Psychiatric diagnostic evaluation | 595 | 418 | $0.00 |
| D2150 | Silver amalgam - two surfaces, primary or permanent | 56 | 43 | $0.00 |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 3,790 | 3,123 | $0.00 |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 687 | 652 | $0.00 |
| 81003 | 458 | 395 | $0.00 | |
| 1160F | 54 | 52 | $0.00 | |
| 90658 | 79 | 76 | $0.00 | |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | 1,166 | 1,091 | $0.00 |
| 99203 | Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 124 | 64 | $0.00 |
| 3077F | 231 | 211 | $0.00 | |
| 90837 | Psychotherapy, 53 minutes with patient | 23 | 15 | $0.00 |