Phoenix, Shima

Phoenix, Shima was paid $111K by Medicaid between Jan 2018 and Mar 2019, across 16 billing codes. Its largest line is D1120, dental cleaning, child — 15% of everything it billed.

33Billing provider infoPHOENIX, SHIMA
MOUNT VERNON, IL 62864

33aNPI1588040976assigned 08/07/2015

33bProvider typeDentist

28Total paid$111K

24GClaims5,144

24DCodes billed16

24AFirst – last monthJan 2018 – Mar 2019

Compared with peers

Next to other Dentist providers in Illinois

Rank by total paid#612 of 1,099

Median peer was paid$160K

This provider vs. median0.7×

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
2018	2,752	$59K
2019	2,392	$53K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1120	Dental cleaning, childProphylaxis - child	15%	459	348	$17K
D7140	Extraction, erupted tooth or exposed root	13%	243	102	$14K
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth	11%	195	115	$13K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	11%	480	389	$12K
D0330	Panoramic radiographic image	7.7%	629	447	$9K
D1208	Topical application of fluoride, excluding varnish	7.7%	392	303	$9K
D1110	Prophylaxis - adult	7.6%	228	177	$8K
D0150	Comprehensive oral evaluation - new or established patient	6.8%	347	288	$8K
D0210	Intraoral - complete series of radiographic images	6.1%	410	277	$7K
D2391	Resin-based composite - one surface, posterior, primary or permanent	2.9%	78	52	$3K
D0220	Intraoral - periapical first radiographic image	2.6%	751	545	$3K
D0274	Bitewings - four radiographic images	2.3%	124	111	$3K

4 more codes

D0140	Limited oral evaluation - problem focused	2.1%	161	$2K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	1.7%	37	$2K
D0230	Intraoral - periapical each additional radiographic image	1.3%	557	$1K
D1206	Topical application of fluoride varnish	1.1%	53	$1K

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.