Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

SALT CITY DENTAL, P.A.

NPI: 1629811484 · HUTCHINSON, KS 67502 · General Practice Dentistry · NPI assigned 06/18/2024

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official CARDON, CREED controls 20+ related entities in our dataset. Read more

$13K
Total Medicaid Paid
599
Total Claims
495
Beneficiaries
9
Codes Billed
2024-09
First Month
2024-11
Last Month

Provider Details

Authorized OfficialCARDON, CREED (PRESIDENT)
NPI Enumeration Date06/18/2024

Related Entities

Other providers sharing the same authorized official: CARDON, CREED

ProviderCityStateTotal Paid
MCO PEDS PLLC JENKS OK $2.51M
OKLAHOMA CITY DENTAL SW, PLLC OKLAHOMA CITY OK $1.24M
SUMMER DENTAL STILLWATER, PLLC STILLWATER OK $1.22M
SAPULPA KIDS DENTAL PLLC SAPULPA OK $1.12M
SPRING ORTHODONTICS TULSA TULSA OK $1.03M
SPRING DENTAL COLLINSVILLE, PLLC COLLINSVILLE OK $1.01M
OKC 89TH DENTAL, PLLC OKLAHOMA CITY OK $962K
TULSA KIDS DENTAL PLLC TULSA OK $857K
WITCHITA 21ST DENTAL, PA WICHITA KS $802K
SUMMER DENTAL MIDWEST CITY, PLLC MIDWEST CITY OK $454K
SPRING DENTAL VINITA, PLLC VINITA OK $371K
RIVER DENTAL SILOAM SPRINGS, PLLC SILOAM SPRINGS AR $267K
ELITE ORAL AND MAXILLOFACIAL SURGERY OF OKLAHOMA, PLLC TULSA OK $194K
COTTONWOOD DENTAL MAIZE, PA WICHITA KS $186K
REDBUD DENTAL EDMOND, PLLC EDMOND OK $157K
DENTAL CARE OF WICHITA PA WICHITA KS $73K
RIVER DENTAL ROGERS SOUTH, PLLC ROGERS AR $66K
RIVER DENTAL ROGERS, PLLC ROGERS AR $61K
MARION FAMILY SMILES, P.A. MARION KS $56K
OWASSO PEDIATRIC DENTISTRY, PLLC OWASSO OK $45K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2024 599 $13K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1110 Prophylaxis - adult 60 56 $3K
D1351 Sealant - per tooth 80 14 $2K
D0274 Bitewings - four radiographic images 68 64 $2K
D0330 Panoramic radiographic image 28 28 $1K
D1206 Topical application of fluoride varnish 72 67 $1K
D0120 Periodic oral evaluation - established patient 57 52 $1K
D0220 Intraoral - periapical first radiographic image 105 94 $1K
D0150 Comprehensive oral evaluation - new or established patient 34 34 $996.00
D0230 Intraoral - periapical each additional radiographic image 95 86 $893.10