Dewi S. Sudjono-Santoso

Dewi S. Sudjono-Santoso was paid $1.54M by Medicaid between Jan 2018 and Dec 2024, across 45 billing codes. Its largest line is 90460, Immunization administration through 18 years of age via any route, first or only component — 21% of everything it billed.

33Billing provider infoDEWI S. SUDJONO-SANTOSO
CRANBURY, NJ 08512

33aNPI1124417639assigned 01/21/2015

33bProvider typePediatric Adolescent Medicine Physician

28Total paid$1.54M

24GClaims93,820

24DCodes billed45

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Pediatric Adolescent Medicine Physician providers in New Jersey

Rank by total paid#12 of 56

Median peer was paid$178K

This provider vs. median8.7×

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	11,807	$162K
2019	12,738	$206K
2020	11,545	$206K
2021	13,153	$243K
2022	16,816	$260K
2023	17,170	$275K
2024incomplete	10,591	$193K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
90460	Immunization administration through 18 years of age via any route, first or only component	21%	14,306	13,865	$318K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	16%	28,032	24,573	$253K
99392	Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years)	11%	3,952	3,893	$169K
99393	Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years)	9.8%	3,890	3,806	$152K
96110	Developmental screening, with scoring and documentation, per standardized instrument	9.4%	6,726	6,606	$145K
99394	Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years)	7.1%	2,516	2,434	$109K
99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	6.2%	2,174	2,143	$95K
90461		5.7%	4,811	4,710	$88K
90651		3.0%	801	761	$46K
90734		1.6%	727	695	$24K
90671		1.4%	117	117	$21K
90620		1.4%	375	342	$21K

33 more codes

99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	2,566	$14K
90686		<1%	4,019	$14K
90697		<1%	120	$13K
90710		<1%	555	$13K
90658		<1%	932	$11K
90670		<1%	823	$11K
99401		<1%	2,598	$5K
90633		<1%	781	$3K
87430		<1%	1,453	$3K
90744		<1%	583	$3K
90715		<1%	279	$2K
99173		<1%	3,439	$2K
99203	Doctor's office visit, new patient (routine)	<1%	41	$2K
97803		<1%	1,463	$1K
99383		<1%	28	$1K
G0473	Face-to-face behavioral counseling for obesity, group (2-10), 30 minutes	<1%	1,281	$960.41
90696		<1%	105	$775.78
99381		<1%	14	$737.97
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	<1%	2,509	$713.20
90700		<1%	197	$583.53
96160		<1%	310	$431.44
G0447	Face-to-face behavioral counseling for obesity, 15 minutes	<1%	268	$425.32
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	<1%	13	$183.85
94664		<1%	18	$180.02
90655		<1%	25	$150.82
90648		<1%	141	$122.63
96161		<1%	34	$16.91
G9920	Screening performed and negative	<1%	34	$12.00
99000		<1%	611	$7.50
90698		0%	96	$0.00
90723		0%	12	$0.00
90680		0%	14	$0.00
90681		0%	31	$0.00

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.

From NPPES

Who's on the registration

Authorized officialSUDJONO-SANTOSO, DEWI (OWNER)

Parent organizationDEWI S. SUDJONO-SANTOSO