RICHARDSON, JACQUELYN
NPI: 1780853366
· MOLINE, IL 61265
· Dentist
· NPI assigned 02/27/2008
$118K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
3,173 |
$118K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1351 |
Sealant - per tooth |
649 |
391 |
$44K |
| D1120 |
Prophylaxis - child |
744 |
744 |
$32K |
| D0120 |
Periodic oral evaluation - established patient |
769 |
769 |
$23K |
| D1206 |
Topical application of fluoride varnish |
733 |
733 |
$20K |
| D0603 |
|
62 |
62 |
$0.00 |
| D0602 |
|
118 |
118 |
$0.00 |
| D0601 |
|
98 |
98 |
$0.00 |