NPI: 1770620742 · JACKSONVILLE, FL 32216 · Ambulatory Surgical Clinic/Center · NPI assigned 01/31/2007
Authorized official LARSEN, DEVIN controls 20+ related entities in our dataset. Read more
| Authorized Official | LARSEN, DEVIN (CEO) |
| NPI Enumeration Date | 01/31/2007 |
Other providers sharing the same authorized official: LARSEN, DEVIN
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 1,493 | $88K |
| 2023 | 51,058 | $3.24M |
| 2024 | 19,984 | $2.99M |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D7140 | Extraction, erupted tooth or exposed root | 12,227 | 3,216 | $2.32M |
| D2930 | Prefabricated stainless steel crown - primary tooth | 11,355 | 3,223 | $1.54M |
| D9420 | 5,925 | 4,334 | $984K | |
| 41899 | Unlisted procedure, dentoalveolar structures | 515 | 498 | $573K |
| D7111 | 1,048 | 440 | $183K | |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 1,506 | 781 | $179K |
| D0150 | Comprehensive oral evaluation - new or established patient | 5,648 | 3,875 | $151K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 747 | 408 | $118K |
| D0603 | 5,476 | 3,914 | $111K | |
| D2330 | 2,068 | 930 | $70K | |
| D2934 | 898 | 398 | $31K | |
| D0350 | 5,273 | 3,733 | $28K | |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 2,032 | 989 | $17K |
| D0210 | Intraoral - complete series of radiographic images | 5,345 | 3,788 | $6K |
| D1330 | 5,312 | 3,775 | $4K | |
| D3120 | 295 | 125 | $1K | |
| D1351 | Sealant - per tooth | 6,693 | 2,211 | $1K |
| D0140 | Limited oral evaluation - problem focused | 15 | 15 | $0.00 |
| D2331 | 63 | 13 | $0.00 | |
| D2332 | 94 | 36 | $0.00 |