Iwaszczyszyn, Agnieszka

Iwaszczyszyn, Agnieszka was paid $43K by Medicaid between Oct 2018 and May 2019, across 12 billing codes. Its largest line is D1120, dental cleaning, child — 26% of everything it billed.

33Billing provider infoIWASZCZYSZYN, AGNIESZKA
LA GRANGE, IL 60525

33aNPI1821441312assigned 07/19/2016

33bProvider typeDentist

28Total paid$43K

24GClaims1,673

24DCodes billed12

24AFirst – last monthOct 2018 – May 2019

Compared with peers

Next to other Dentist providers in Illinois

Rank by total paid#763 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
2018	642	$17K
2019	1,031	$26K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1120	Dental cleaning, childProphylaxis - child	26%	302	270	$11K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	20%	331	300	$9K
D1208	Topical application of fluoride, excluding varnish	16%	291	259	$7K
D7140	Extraction, erupted tooth or exposed root	14%	134	80	$6K
D0274	Bitewings - four radiographic images	4.6%	126	115	$2K
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth	4.4%	23	18	$2K
D0140	Limited oral evaluation - problem focused	3.9%	127	108	$2K
D1110	Prophylaxis - adult	3.5%	41	39	$2K
D0220	Intraoral - periapical first radiographic image	2.1%	186	155	$924.00
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	2.1%	17	13	$914.85
D0150	Comprehensive oral evaluation - new or established patient	1.9%	43	37	$820.95
D0272	Bitewings - two radiographic images	1.1%	52	42	$460.60

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.