Dental
Susanto Dental Corporation
Susanto Dental Corporation was paid $45K by Medicaid between Jan 2018 and Aug 2021, across 7 billing codes. Its largest line is D0120, dental checkup, returning patient — 35% of everything it billed.
33Billing provider infoSUSANTO DENTAL CORPORATION
LA PUENTE, CA 91744
LA PUENTE, CA 91744
33aNPI1609061720assigned 09/11/2007
33bProvider typeDentist
28Total paid$45K
24GClaims2,566
24DCodes billed7
24AFirst – last monthJan 2018 – Aug 2021
Compared with peers
Next to other Dentist providers in California
Rank by total paid#1,573 of 2,314
Median peer was paid$185K
This provider vs. median0.2×
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 | 1,115 | $18K | |
| 2019 | 747 | $13K | |
| 2020 | 398 | $8K | |
| 2021 | 306 | $6K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 35% | 419 | 419 | $16K |
| D1120 | Dental cleaning, childProphylaxis - child | 30% | 486 | 486 | $14K |
| D0272 | Bitewings - two radiographic images | 13% | 515 | 510 | $6K |
| D0230 | Intraoral - periapical each additional radiographic image | 11% | 603 | 573 | $5K |
| D1208 | Topical application of fluoride, excluding varnish | 8.0% | 454 | 454 | $4K |
| D0274 | Bitewings - four radiographic images | 1.7% | 40 | 40 | $756.00 |
| D1206 | Topical application of fluoride varnish | 1.2% | 49 | 49 | $542.00 |
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 officialSUSANTO, HANNY (PRESIDENT)