Dental
Santan Kidtastic LLC
Santan Kidtastic LLC was paid $6K by Medicaid between Jan 2019 and Oct 2019, across 8 billing codes. Its largest line is D1206, Topical application of fluoride varnish — 34% of everything it billed.
33Billing provider infoSANTAN KIDTASTIC LLC
SAN TAN VALLEY, AZ 85143
SAN TAN VALLEY, AZ 85143
33aNPI1669726030assigned 11/06/2012
33bProvider typePediatric Dentist
28Total paid$6K
24GClaims402
24DCodes billed8
24AFirst – last monthJan 2019 – Oct 2019
Compared with peers
Next to other Pediatric Dentist providers in Arizona
Rank by total paid#148 of 223
Median peer was paid$24K
This provider vs. median0.3×
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 | |
|---|---|---|---|
| 2019 | 402 | $6K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1206 | Topical application of fluoride varnish | 34% | 156 | 134 | $2K |
| D1120 | Dental cleaning, childProphylaxis - child | 29% | 76 | 59 | $2K |
| D0150 | Comprehensive oral evaluation - new or established patient | 8.5% | 15 | 15 | $546.60 |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 8.0% | 22 | 22 | $515.24 |
| D0220 | Intraoral - periapical first radiographic image | 5.5% | 51 | 46 | $351.60 |
| D0240 | 5.3% | 24 | 18 | $339.50 | |
| D0230 | Intraoral - periapical each additional radiographic image | 5.1% | 36 | 33 | $327.42 |
| D0272 | Bitewings - two radiographic images | 3.8% | 22 | 22 | $244.66 |
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 officialJOHNSON, JAIME (CONTROLL)
| Provider | Location | Paid |
|---|---|---|
| Sun Valley Pediatric Dentistry, PLLC | Avondale, AZ | $267K |
| Higley Village Kidtastic, LLC | Gilbert, AZ | $67K |
| Fiesta Kidtastic, LLC | Mesa, AZ | $21K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.