Dental
Elmosa, Sammy
Elmosa, Sammy was paid $1.73M by Medicaid between Jan 2018 and Dec 2024, across 22 billing codes. Its largest line is D2750, — 20% of everything it billed.
33Billing provider infoELMOSA, SAMMY
BURBANK, IL 60459
BURBANK, IL 60459
33aNPI1891824199assigned 03/04/2007
33bProvider typeGeneral Practice Dentistry
28Total paid$1.73M
24GClaims46,603
24DCodes billed22
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in Illinois
Rank by total paid#59 of 1,017
Median peer was paid$123K
This provider vs. median14×
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 | 6,274 | $236K | |
| 2019 | 7,855 | $309K | |
| 2020 | 7,308 | $315K | |
| 2021 | 5,557 | $174K | |
| 2022 | 6,448 | $207K | |
| 2023 | 6,995 | $260K | |
| 2024incomplete | 6,166 | $224K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2750 | 20% | 1,059 | 783 | $348K | |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 11% | 7,585 | 7,149 | $194K |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 10% | 2,219 | 1,719 | $173K |
| D1110 | Prophylaxis - adult | 9.3% | 4,167 | 3,944 | $160K |
| D2740 | Crown - porcelain/ceramic | 8.8% | 468 | 405 | $152K |
| D0274 | Bitewings - four radiographic images | 7.3% | 8,687 | 8,207 | $126K |
| D1120 | Dental cleaning, childProphylaxis - child | 6.8% | 3,130 | 2,961 | $118K |
| D2950 | 6.7% | 1,804 | 1,458 | $116K | |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 3.3% | 1,114 | 787 | $57K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 3.2% | 847 | 686 | $55K |
| D0140 | Limited oral evaluation - problem focused | 3.1% | 3,856 | 3,570 | $54K |
| D0150 | Comprehensive oral evaluation - new or established patient | 3.0% | 2,292 | 2,191 | $51K |
10 more codes
| D1208 | Topical application of fluoride, excluding varnish | 2.5% | 1,827 | $44K |
| D0220 | Intraoral - periapical first radiographic image | 1.3% | 4,375 | $23K |
| D3310 | 1.0% | 86 | $18K | |
| D0330 | Panoramic radiographic image | <1% | 497 | $11K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 121 | $10K |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 2,188 | $8K |
| D2332 | <1% | 56 | $5K | |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 41 | $2K |
| D0272 | Bitewings - two radiographic images | <1% | 142 | $1K |
| D0210 | Intraoral - complete series of radiographic images | <1% | 42 | $617.00 |
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.