RACKAUSKAS, MARY
NPI: 1982734919
· SPRINGFIELD, IL 62704
· Pediatric Dentist
· NPI assigned 03/07/2007
$113K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
318 |
$8K |
| 2020 |
762 |
$22K |
| 2021 |
97 |
$4K |
| 2022 |
473 |
$19K |
| 2023 |
1,476 |
$54K |
| 2024 |
115 |
$6K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1351 |
Sealant - per tooth |
640 |
399 |
$42K |
| D1120 |
Prophylaxis - child |
743 |
715 |
$31K |
| D0120 |
Periodic oral evaluation - established patient |
750 |
720 |
$21K |
| D1206 |
Topical application of fluoride varnish |
740 |
712 |
$19K |
| D0601 |
|
217 |
217 |
$0.00 |
| D0603 |
|
41 |
41 |
$0.00 |
| D0602 |
|
110 |
109 |
$0.00 |