Montalvan, Ericka

Montalvan, Ericka was paid $35K by Medicaid between May 2019 and Sep 2020, across 9 billing codes. Its largest line is D1120, dental cleaning, child — 40% of everything it billed.

33Billing provider infoMONTALVAN, ERICKA
SMITHTOWN, NY 11787

33aNPI1407034416assigned 02/01/2008

33bProvider typePediatric Dentist

28Total paid$35K

24GClaims1,407

24DCodes billed9

24AFirst – last monthMay 2019 – Sep 2020

Compared with peers

Next to other Pediatric Dentist providers in New York

Rank by total paid#380 of 514

Median peer was paid$196K

This provider vs. median0.2×

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
2019	511	$13K
2020	896	$21K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1120	Dental cleaning, childProphylaxis - child	40%	393	393	$14K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	21%	292	292	$7K
D1208	Topical application of fluoride, excluding varnish	9.6%	281	281	$3K
D1206	Topical application of fluoride varnish	8.1%	111	111	$3K
D0150	Comprehensive oral evaluation - new or established patient	7.2%	102	102	$3K
D0272	Bitewings - two radiographic images	6.6%	159	159	$2K
D1110	Prophylaxis - adult	5.0%	35	35	$2K
D0330	Panoramic radiographic image	1.3%	17	17	$467.36
D0274	Bitewings - four radiographic images	1.2%	17	17	$415.91

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.