Dental
Tolosa Childrens Dental Center
Tolosa Childrens Dental Center was paid $772K by Medicaid between Jan 2018 and Dec 2024, across 22 billing codes. Its largest line is D0120, dental checkup, returning patient — 32% of everything it billed.
33Billing provider infoTOLOSA CHILDRENS DENTAL CENTER
SAN LUIS OBISPO, CA 93401
SAN LUIS OBISPO, CA 93401
33aNPI1295139590assigned 10/15/2014
33bProvider typePediatric Dentist
28Total paid$772K
24GClaims38,265
24DCodes billed22
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in California
Rank by total paid#147 of 332
Median peer was paid$450K
This provider vs. median1.7×
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 | 4,204 | $62K | |
| 2019 | 4,660 | $79K | |
| 2020 | 4,241 | $68K | |
| 2021 | 5,560 | $83K | |
| 2022 | 5,675 | $131K | |
| 2023 | 6,265 | $151K | |
| 2024incomplete | 7,660 | $198K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 32% | 4,161 | 4,147 | $249K |
| D1120 | Dental cleaning, childProphylaxis - child | 27% | 5,179 | 5,156 | $208K |
| D1206 | Topical application of fluoride varnish | 9.6% | 5,157 | 5,126 | $74K |
| D0230 | Intraoral - periapical each additional radiographic image | 7.8% | 15,333 | 4,223 | $60K |
| D1310 | 4.2% | 996 | 990 | $33K | |
| D0274 | Bitewings - four radiographic images | 3.7% | 1,425 | 1,419 | $28K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 2.6% | 303 | 210 | $20K |
| D0272 | Bitewings - two radiographic images | 2.4% | 1,664 | 1,654 | $19K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 2.4% | 472 | 440 | $19K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 1.2% | 74 | 54 | $9K |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.1% | 145 | 145 | $9K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 1.1% | 155 | 118 | $8K |
10 more codes
| D0270 | <1% | 1,495 | $7K | |
| D1351 | Sealant - per tooth | <1% | 234 | $7K |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 89 | $5K |
| D0603 | <1% | 544 | $5K | |
| D0220 | Intraoral - periapical first radiographic image | <1% | 342 | $4K |
| D0350 | <1% | 349 | $3K | |
| D0330 | Panoramic radiographic image | <1% | 67 | $2K |
| D0210 | Intraoral - complete series of radiographic images | <1% | 25 | $1K |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 19 | $1K |
| D0601 | <1% | 37 | $540.00 |
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 officialRUSSELL, SUZANNE (CLINIC DIRECTOR)
Parent organizationTOLOSA CHILDREN'S DENTAL CENTER