Kowalczyk, Annette

Kowalczyk, Annette was paid $55K by Medicaid between Mar 2019 and Oct 2020, across 6 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 32% of everything it billed.

33Billing provider infoKOWALCZYK, ANNETTE
BREWSTER, NY 10509

33aNPI1528465465assigned 11/20/2014

33bProvider typeDentist

28Total paid$55K

24GClaims1,342

24DCodes billed6

24AFirst – last monthMar 2019 – Oct 2020

Compared with peers

Next to other Dentist providers in New York

Rank by total paid#796 of 1,649

Median peer was paid$49K

This provider vs. median1.1×

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	1,199	$49K
2020	143	$6K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	32%	312	155	$17K
D2391	Resin-based composite - one surface, posterior, primary or permanent	26%	326	113	$14K
D1110	Prophylaxis - adult	14%	260	260	$8K
D2393	Resin-based composite - three surfaces, posterior, primary or permanent	14%	105	56	$7K
D0210	Intraoral - complete series of radiographic images	8.4%	133	133	$5K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	6.2%	206	206	$3K

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.