Listwa, Jessica

Listwa, Jessica was paid $275K by Medicaid between Oct 2018 and Sep 2022, across 18 billing codes. Its largest line is D1120, dental cleaning, child — 27% of everything it billed.

33Billing provider infoLISTWA, JESSICA
HACKENSACK, NJ 07601

33aNPI1306293469assigned 05/18/2016

33bProvider typePediatric Dentist

28Total paid$275K

24GClaims9,446

24DCodes billed18

24AFirst – last monthOct 2018 – Sep 2022

Compared with peers

Next to other Pediatric Dentist providers in New Jersey

Rank by total paid#97 of 190

Median peer was paid$275K

This provider vs. median1.0×

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	48	$3K
2019	198	$12K
2020	1,982	$54K
2021	4,621	$130K
2022	2,597	$75K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1120	Dental cleaning, childProphylaxis - child	27%	1,585	1,584	$73K
D1206	Topical application of fluoride varnish	20%	1,740	1,739	$54K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	14%	563	334	$39K
D1351	Sealant - per tooth	14%	1,865	422	$38K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	14%	1,440	1,438	$38K
D0330	Panoramic radiographic image	3.2%	211	211	$9K
D0272	Bitewings - two radiographic images	2.0%	522	522	$5K
D0602		1.9%	568	567	$5K
D0603		1.4%	407	407	$4K
D0150	Comprehensive oral evaluation - new or established patient	<1%	95	95	$3K
D0274	Bitewings - four radiographic images	<1%	184	184	$2K
D1110	Prophylaxis - adult	<1%	27	27	$1K

6 more codes

D0601		<1%	109	$1K
D0145	Oral evaluation for a patient under three years of age	<1%	12	$540.00
D0350		<1%	76	$380.00
D9920		<1%	15	$375.00
D0140	Limited oral evaluation - problem focused	<1%	13	$340.00
D0220	Intraoral - periapical first radiographic image	<1%	14	$70.00

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.