FORT MYERS CHILDREN'S SURGERY CENTER, LLC

NPI: 1366549511 · FT MYERS, FL 33901 · Ambulatory Surgical Clinic/Center · NPI assigned 09/20/2006

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

Authorized official LARSEN, DEVIN controls 20+ related entities in our dataset. Read more

$3.42M

Total Medicaid Paid

43,173

Total Claims

24,035

Beneficiaries

Codes Billed

2023-08

First Month

2024-12

Last Month

Provider Details

Authorized Official	LARSEN, DEVIN (CEO)
NPI Enumeration Date	09/20/2006

Other providers sharing the same authorized official: LARSEN, DEVIN

Provider	City	State	Total Paid
VALLARINE DENTAL CORPORATION	FRESNO	CA	$38.23M
COFFEE SURGERY CENTER, LLC	BAKERSFIELD	CA	$14.86M
KC CHILDRENS SURGERY CENTER LLC	KANSAS CITY	KS	$13.76M
HOUSTON CHILDREN'S DENTAL CENTER, LLC	HOUSTON	TX	$11.03M
DENTAL SURGICENTER OF LOUISVILLE LLC	LOUISVILLE	KY	$8.44M
DENTAL SURGERY CENTERS OF AMERICA	ATWATER	CA	$7.22M
DENTAL SURGERY CENTERS OF AMERICA	STOCKTON	CA	$6.82M
JACKSONVILLE CHILDREN'S SURGERY CENTER, LLC	JACKSONVILLE	FL	$6.31M
MEDICAL AND DENTAL CENTER OF NEVADA LLC	LAS VEGAS	NV	$6.00M
SAN ANTONIO CHILDRENS SURGICAL	SAN ANTONIO	TX	$4.91M
CHILDREN 1ST HOUSTON SOUTH, LLC	HOUSTON	TX	$3.69M
VISALIA CHILDREN'S DENTAL SURGERY CENTER INC	VISALIA	CA	$3.35M
CHILDREN 1ST GRAND PRAIRIE, LLC	GRAND PRAIRIE	TX	$3.31M
DENTAL SURGERY CENTERS OF AMERICA	SANTA MARIA	CA	$2.66M
WEST PALM BEACH CHILDREN'S SURGERY CENTER, LLC	PALM SPRINGS	FL	$1.63M
BLUE CLOUD ANESTHESIA, LLC	TAMPA	FL	$1.57M
SURGICAL CENTER FOR DENTAL PROFESSIONALS OF NC LLC	RALEIGH	NC	$1.38M
BLUE CLOUD ANESTHESIA, LLC	ORLANDO	FL	$1.36M
DENTAL SURGICENTER OF LOUISVILLE LLC	LOUISVILLE	KY	$965K
THE DIGESTIVE ENDOSCOPY CENTER OF MICHIGAN LLC	FLINT	MI	$759K

Year	Claims	Total Paid
2023	8,510	$485K
2024	34,663	$2.93M

Code	Description	Claims	Beneficiaries	Total Paid
D7140	Extraction, erupted tooth or exposed root	7,269	2,161	$1.59M
D2930	Prefabricated stainless steel crown - primary tooth	6,549	2,235	$1.11M
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	1,196	684	$291K
D2391	Resin-based composite - one surface, posterior, primary or permanent	1,591	839	$175K
D2335		292	157	$137K
D2330		1,372	768	$49K
D2934		368	184	$13K
D2332		257	180	$13K
D3220	Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction	801	533	$11K
D3120		920	526	$11K
D9420		3,581	2,647	$9K
D0210	Intraoral - complete series of radiographic images	3,583	2,636	$4K
D2331		23	14	$2K
D0150	Comprehensive oral evaluation - new or established patient	3,605	2,648	$2K
D1351	Sealant - per tooth	3,175	1,411	$834.30
D1330		3,599	2,646	$592.36
D0350		1,433	1,146	$260.75
D0603		3,559	2,620	$20.05