LAKEWOOD PEDIATRIC DENTISTRY PLLC
NPI: 1417499500
· LAKEWOOD, NY 14750
· Pediatric Dentist
· NPI assigned 11/07/2016
$161K
Total Medicaid Paid
Provider Details
| Authorized Official | CARLSON, JAN (OWNER/DENTIST) |
| NPI Enumeration Date | 11/07/2016 |
Related Entities
Other providers sharing the same authorized official: CARLSON, JAN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
346 |
$10K |
| 2020 |
1,372 |
$36K |
| 2021 |
1,651 |
$44K |
| 2022 |
1,654 |
$45K |
| 2023 |
963 |
$26K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
1,596 |
1,596 |
$67K |
| D0120 |
Periodic oral evaluation - established patient |
1,653 |
1,653 |
$44K |
| D1206 |
Topical application of fluoride varnish |
590 |
590 |
$17K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,110 |
1,110 |
$15K |
| D0272 |
Bitewings - two radiographic images |
775 |
775 |
$12K |
| D1110 |
Prophylaxis - adult |
75 |
75 |
$4K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
48 |
48 |
$1K |
| D0140 |
Limited oral evaluation - problem focused |
12 |
12 |
$163.10 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
127 |
124 |
$0.00 |