Dental
Liston, Lawrence
Liston, Lawrence was paid $54K by Medicaid between Dec 2021 and Jun 2023, across 11 billing codes. Its largest line is D0120, dental checkup, returning patient — 62% of everything it billed.
33Billing provider infoLISTON, LAWRENCE
BLOOMINGTON, IL 61701
BLOOMINGTON, IL 61701
33aNPI1568616886assigned 11/13/2008
33bProvider typeDentist
28Total paid$54K
24GClaims693
24DCodes billed11
24AFirst – last monthDec 2021 – Jun 2023
Compared with peers
Next to other Dentist providers in Illinois
Rank by total paid#734 of 1,099
Median peer was paid$160K
This provider vs. median0.3×
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 | |
|---|---|---|---|
| 2021 | 127 | $7K | |
| 2022 | 304 | $38K | |
| 2023 | 262 | $8K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 62% | 332 | 328 | $34K |
| D0150 | Comprehensive oral evaluation - new or established patient | 18% | 92 | 92 | $10K |
| D7140 | Extraction, erupted tooth or exposed root | 9.6% | 45 | 40 | $5K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 3.3% | 14 | 13 | $2K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 3.2% | 13 | 12 | $2K |
| D1120 | Dental cleaning, childProphylaxis - child | 2.2% | 65 | 65 | $1K |
| D0210 | Intraoral - complete series of radiographic images | <1% | 14 | 14 | $331.10 |
| D1206 | Topical application of fluoride varnish | <1% | 48 | 48 | $260.94 |
| D0330 | Panoramic radiographic image | <1% | 12 | 12 | $110.40 |
| D0601 | 0% | 38 | 38 | $0.00 | |
| D0274 | Bitewings - four radiographic images | 0% | 20 | 20 | $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.