Physician
Candlewood Valley Pediatrics, P.C.
Candlewood Valley Pediatrics, P.C. was paid $3.25M by Medicaid between Jan 2018 and Oct 2024, across 42 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 58% of everything it billed.
33Billing provider infoCANDLEWOOD VALLEY PEDIATRICS, P.C.
NEW MILFORD, CT 06776
NEW MILFORD, CT 06776
33aNPI1811021066assigned 03/16/2007
33bProvider typePediatrics Physician
28Total paid$3.25M
24GClaims71,411
24DCodes billed42
24AFirst – last monthJan 2018 – Oct 2024
Compared with peers
Next to other Pediatrics Physician providers in Connecticut
Rank by total paid#25 of 162
Median peer was paid$313K
This provider vs. median10×
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 | |
|---|---|---|---|
| 2018 | 9,803 | $465K | |
| 2019 | 9,593 | $467K | |
| 2020 | 8,640 | $374K | |
| 2021 | 11,796 | $443K | |
| 2022 | 12,460 | $564K | |
| 2023 | 10,526 | $521K | |
| 2024incomplete | 8,593 | $420K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 58% | 24,613 | 22,195 | $1.88M |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 10% | 7,936 | 7,587 | $332K |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 8.4% | 2,434 | 2,224 | $274K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 4.9% | 1,166 | 1,129 | $159K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 3.4% | 905 | 868 | $111K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 3.3% | 2,341 | 2,250 | $109K |
| 96127 | 2.1% | 3,125 | 2,963 | $67K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1.7% | 468 | 439 | $56K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 1.3% | 611 | 556 | $43K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 1.3% | 1,757 | 1,693 | $42K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 1.1% | 1,300 | 1,238 | $37K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 940 | 893 | $28K |
30 more codes
| 92558 | <1% | 1,124 | $26K | |
| 99173 | <1% | 3,605 | $25K | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 170 | $19K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 147 | $7K |
| 99051 | <1% | 794 | $6K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 203 | $5K |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | <1% | 251 | $5K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 393 | $4K |
| 94760 | <1% | 2,389 | $3K | |
| 99188 | <1% | 88 | $2K | |
| 90686 | <1% | 4,363 | $2K | |
| 36416 | <1% | 428 | $1K | |
| 99174 | <1% | 69 | $1K | |
| 99177 | <1% | 62 | $1K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 54 | $978.77 |
| 96160 | <1% | 44 | $820.65 | |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 29 | $806.00 |
| D1206 | Topical application of fluoride varnish | <1% | 13 | $322.40 |
| 83655 | <1% | 14 | $150.28 | |
| 92551 | <1% | 14 | $90.86 | |
| 85018 | <1% | 1,525 | $76.84 | |
| 90656 | <1% | 334 | $22.35 | |
| 3008F | 0% | 4,311 | $0.00 | |
| 90723 | 0% | 26 | $0.00 | |
| 90680 | 0% | 14 | $0.00 | |
| 90647 | 0% | 12 | $0.00 | |
| 99000 | 0% | 14 | $0.00 | |
| 90461 | 0% | 1,465 | $0.00 | |
| 99072 | 0% | 1,765 | $0.00 | |
| 90670 | 0% | 95 | $0.00 |
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.
From NPPES
Who's on the registration
Authorized officialDECRESCENZO, MARILYN (MANAGED CARE COORDINATOR)