Dental
Sam, Sima
Sam, Sima was paid $1.58M by Medicaid between Jan 2018 and Dec 2024, across 23 billing codes. Its largest line is D1120, dental cleaning, child — 30% of everything it billed.
33Billing provider infoSAM, SIMA
ROCKFORD, IL 61102
ROCKFORD, IL 61102
33aNPI1982617478assigned 08/14/2006
33bProvider typeGeneral Practice Dentistry
28Total paid$1.58M
24GClaims59,363
24DCodes billed23
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in Illinois
Rank by total paid#68 of 1,017
Median peer was paid$123K
This provider vs. median13×
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 | 11,245 | $300K | |
| 2019 | 13,810 | $378K | |
| 2020 | 2,871 | $72K | |
| 2021 | 5,296 | $133K | |
| 2022 | 8,069 | $209K | |
| 2023 | 9,498 | $260K | |
| 2024incomplete | 8,574 | $231K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 30% | 11,668 | 11,303 | $471K |
| D1206 | Topical application of fluoride varnish | 19% | 11,533 | 11,172 | $295K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 18% | 10,274 | 9,955 | $284K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 8.0% | 2,216 | 1,864 | $127K |
| D1351 | Sealant - per tooth | 7.2% | 1,543 | 1,093 | $115K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 3.5% | 1,494 | 1,287 | $55K |
| D0220 | Intraoral - periapical first radiographic image | 2.4% | 6,351 | 6,116 | $38K |
| D0272 | Bitewings - two radiographic images | 2.3% | 3,637 | 3,497 | $36K |
| D0230 | Intraoral - periapical each additional radiographic image | 2.0% | 5,765 | 5,445 | $31K |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.9% | 1,304 | 1,255 | $30K |
| D0274 | Bitewings - four radiographic images | 1.3% | 1,107 | 1,091 | $21K |
| D7140 | Extraction, erupted tooth or exposed root | 1.2% | 410 | 350 | $18K |
11 more codes
| D2930 | Prefabricated stainless steel crown - primary tooth | 1.1% | 239 | $18K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | <1% | 530 | $13K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 119 | $6K |
| D9310 | <1% | 330 | $5K | |
| D0140 | Limited oral evaluation - problem focused | <1% | 305 | $5K |
| D1354 | <1% | 123 | $4K | |
| D0210 | Intraoral - complete series of radiographic images | <1% | 195 | $3K |
| D0330 | Panoramic radiographic image | <1% | 143 | $3K |
| D2330 | <1% | 45 | $2K | |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | <1% | 15 | $790.50 |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 17 | $442.00 |
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.