VALUDENTAL ST JOSEPH LLC

NPI: 1417647678 · SAINT JOSEPH, MO 64506 · Dental Clinic/Center · NPI assigned 05/11/2023

$106K

Total Medicaid Paid

2,468

Total Claims

2,043

Beneficiaries

Codes Billed

2024-02

First Month

2024-12

Last Month

Provider Details

Authorized Official	ESLER, LINDA (OFFICE MANAGER)
NPI Enumeration Date	05/11/2023

Other providers sharing the same authorized official: ESLER, LINDA

Provider	City	State	Total Paid
VALUDENTAL OLATHE LLC	OLATHE	KS	$61K
VALUDENTAL SPRINGFIELD LLC	SPRINGFIELD	MO	$9K
VALUDENTAL ROELAND PARK LLC	ROELAND PARK	KS	$3K
VALUDENTAL TRUMAN CORNERS RUSSELL LLC	GRANDVIEW	MO	$438.30
VALUDENTAL CLINTON LLC	CLINTON	MO	$414.40

Year	Claims	Total Paid
2024	2,468	$106K

Code	Description	Claims	Beneficiaries	Total Paid
D0330	Panoramic radiographic image	559	496	$37K
D0150	Comprehensive oral evaluation - new or established patient	487	444	$27K
D0274	Bitewings - four radiographic images	385	346	$15K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	54	24	$8K
D0220	Intraoral - periapical first radiographic image	488	420	$8K
D0230	Intraoral - periapical each additional radiographic image	464	287	$8K
D0140	Limited oral evaluation - problem focused	14	13	$996.80
D1110	Prophylaxis - adult	17	13	$992.65