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PEDIATRIC DENTAL SEDATION SPECIALIST OF CONNECTICUT LLC
PEDIATRIC DENTAL SEDATION SPECIALIST OF CONNECTICUT LLC
NPI: 1053704445
· NORWALK, CT 06851
· Pediatric Dentist
· NPI assigned 03/10/2015
$1.14M
Total Medicaid Paid
Provider Details
| Authorized Official | LEVY, JESSICA (MEMBER) |
| NPI Enumeration Date | 03/10/2015 |
Related Entities
Other providers sharing the same authorized official: LEVY, JESSICA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,918 |
$382K |
| 2019 |
1,994 |
$392K |
| 2020 |
1,383 |
$240K |
| 2021 |
716 |
$129K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
560 |
527 |
$547K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
2,109 |
420 |
$398K |
| D7140 |
Extraction, erupted tooth or exposed root |
917 |
289 |
$96K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
851 |
826 |
$51K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
478 |
453 |
$26K |
| D0272 |
Bitewings - two radiographic images |
494 |
482 |
$15K |
| D0240 |
|
394 |
383 |
$7K |
| D0220 |
Intraoral - periapical first radiographic image |
155 |
149 |
$3K |
| D1351 |
Sealant - per tooth |
35 |
13 |
$862.40 |
| D0230 |
Intraoral - periapical each additional radiographic image |
18 |
12 |
$299.88 |