Dental
LA Costa Dental of Kostoryz PA
LA Costa Dental of Kostoryz PA was paid $1.62M by Medicaid between Jan 2019 and Dec 2024, across 29 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 14% of everything it billed.
33Billing provider infoLA COSTA DENTAL OF KOSTORYZ PA
CORPUS CHRISTI, TX 78415
CORPUS CHRISTI, TX 78415
33aNPI1245658798assigned 04/02/2014
33bProvider typeDentist
28Total paid$1.62M
24GClaims66,095
24DCodes billed29
24AFirst – last monthJan 2019 – Dec 2024
Compared with peers
Next to other Dentist providers in Texas
Rank by total paid#125 of 1,678
Median peer was paid$35K
This provider vs. median47×
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official PHAN, TIEN controls 20+ related entities in our dataset. Read more
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 | 50 | $556.22 | |
| 2020 | 1,652 | $39K | |
| 2021 | 16,671 | $384K | |
| 2022 | 25,932 | $664K | |
| 2023 | 13,070 | $313K | |
| 2024incomplete | 8,720 | $222K |
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 | 14% | 3,517 | 1,323 | $234K |
| D1351 | Sealant - per tooth | 14% | 9,510 | 1,802 | $223K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 13% | 4,255 | 1,338 | $211K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 8.5% | 5,401 | 5,198 | $139K |
| D1110 | Prophylaxis - adult | 8.4% | 2,859 | 2,765 | $137K |
| D1120 | Dental cleaning, childProphylaxis - child | 6.6% | 3,224 | 3,111 | $106K |
| D1208 | Topical application of fluoride, excluding varnish | 5.0% | 6,286 | 6,078 | $81K |
| D0145 | Oral evaluation for a patient under three years of age | 4.9% | 666 | 653 | $80K |
| D0274 | Bitewings - four radiographic images | 4.3% | 2,968 | 2,865 | $71K |
| D0210 | Intraoral - complete series of radiographic images | 3.6% | 1,652 | 1,543 | $59K |
| D0150 | Comprehensive oral evaluation - new or established patient | 3.1% | 1,674 | 1,593 | $51K |
| D0220 | Intraoral - periapical first radiographic image | 2.6% | 4,441 | 4,273 | $42K |
17 more codes
| D0230 | Intraoral - periapical each additional radiographic image | 2.2% | 4,305 | $35K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 1.9% | 228 | $31K |
| D0330 | Panoramic radiographic image | 1.9% | 2,013 | $30K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 1.4% | 1,858 | $22K |
| D0272 | Bitewings - two radiographic images | 1.3% | 1,134 | $22K |
| D0350 | <1% | 1,318 | $13K | |
| D7240 | Removal of impacted tooth - completely bony | <1% | 38 | $11K |
| D2330 | <1% | 187 | $10K | |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 82 | $7K |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 232 | $6K |
| D2331 | <1% | 26 | $2K | |
| D0140 | Limited oral evaluation - problem focused | <1% | 15 | $315.36 |
| D3120 | <1% | 55 | $86.01 | |
| D1330 | <1% | 27 | $68.02 | |
| D0603 | <1% | 6,232 | $2.05 | |
| D0602 | <1% | 1,310 | $0.15 | |
| D0601 | <1% | 582 | $0.07 |
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 officialPHAN, TIEN (DENTIST)
| Provider | Location | Paid |
|---|---|---|
| Access Dental of Rundberg | Austin, TX | $3.69M |
| Access Dental of Ed Bluestein PA | Austin, TX | $2.50M |
| Access Dental of William Cannon PA | Austin, TX | $1.69M |
| LA Costa Dental of Leopard PA | Corpus Christi, TX | $1.32M |
| Access Dental of Zarzamora PA | San Antonio, TX | $1.17M |
| LA Costa Dental of Ayers PA | Corpus Christi, TX | $1.11M |
| Access Dental of 7TH Street | Austin, TX | $1.06M |
| LA Costa of Beaumont PA | Beaumont, TX | $650K |
| Access Dental of White, P.A. | San Antonio, TX | $564K |
| Access Dental of Meadowbrook | Fort Worth, TX | $549K |
| LA Costa of Port Arthur PA | Port Arthur, TX | $526K |
| Access Dental of Pleasanton, P.A. | San Antonio, TX | $377K |
| Access Dental of Fredericksburg PA | San Antonio, TX | $356K |
| Access Dental of Trawood PLLC | El Paso, TX | $349K |
| Access Dental of Valley Mills PA | Waco, TX | $291K |
| Access Dental of Saginaw | Saginaw, TX | $281K |
| Access Dental of Park Lake PA | Waco, TX | $209K |
| Access Dental of Haltom City | Haltom City, TX | $140K |
| Access Dental of El Paso PLLC | El Paso, TX | $122K |
| Access Dental of Lake June | Dallas, TX | $115K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.