Dental
Simon, Carol
Simon, Carol was paid $32K by Medicaid between Jan 2018 and Jan 2018, across 14 billing codes. Its largest line is D9999, Unspecified adjunctive procedure, by report — 100% of everything it billed.
33Billing provider infoSIMON, CAROL
KENMORE, NY 14217
KENMORE, NY 14217
33aNPI1992971014assigned 05/08/2008
33bProvider typeDentist
28Total paid$32K
24GClaims719
24DCodes billed14
24AFirst – last monthJan 2018 – Jan 2018
Compared with peers
Next to other Dentist providers in New York
Rank by total paid#936 of 1,649
Median peer was paid$49K
This provider vs. median0.6×
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 | 719 | $32K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D9999 | Unspecified adjunctive procedure, by report | 100% | 263 | 196 | $32K |
| D1110 | Prophylaxis - adult | <1% | 82 | 82 | $58.00 |
| D0330 | Panoramic radiographic image | 0% | 32 | 32 | $0.00 |
| D0274 | Bitewings - four radiographic images | 0% | 48 | 48 | $0.00 |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 0% | 24 | 16 | $0.00 |
| D0220 | Intraoral - periapical first radiographic image | 0% | 26 | 26 | $0.00 |
| D1120 | Dental cleaning, childProphylaxis - child | 0% | 25 | 25 | $0.00 |
| D0272 | Bitewings - two radiographic images | 0% | 18 | 18 | $0.00 |
| D1206 | Topical application of fluoride varnish | 0% | 12 | 12 | $0.00 |
| D0150 | Comprehensive oral evaluation - new or established patient | 0% | 17 | 17 | $0.00 |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 0% | 105 | 104 | $0.00 |
| D1208 | Topical application of fluoride, excluding varnish | 0% | 21 | 21 | $0.00 |
2 more codes
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.