Dental
Country Club Dental PA
Country Club Dental PA was paid $11.68M by Medicaid between Jan 2018 and Nov 2024, across 39 billing codes. Its largest line is D1351, Sealant - per tooth — 22% of everything it billed.
33Billing provider infoCOUNTRY CLUB DENTAL PA
TOPEKA, KS 66611
TOPEKA, KS 66611
33aNPI1699137109assigned 03/23/2016
33bProvider typeGeneral Practice Dentistry
28Total paid$11.68M
24GClaims527,959
24DCodes billed39
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other General Practice Dentistry providers in Kansas
Rank by total paid#2 of 203
Median peer was paid$40K
This provider vs. median292×
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official URBANOZO, SHAUN controls 20+ related entities in our dataset. Read more
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 | 32,876 | $655K | |
| 2019 | 52,924 | $1.17M | |
| 2020 | 58,172 | $1.14M | |
| 2021 | 91,998 | $2.01M | |
| 2022 | 99,067 | $2.25M | |
| 2023 | 103,363 | $2.34M | |
| 2024incomplete | 89,559 | $2.12M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1351 | Sealant - per tooth | 22% | 101,346 | 20,106 | $2.56M |
| D2930 | Prefabricated stainless steel crown - primary tooth | 13% | 13,988 | 4,799 | $1.53M |
| D1120 | Dental cleaning, childProphylaxis - child | 8.8% | 31,907 | 30,693 | $1.03M |
| D1206 | Topical application of fluoride varnish | 7.8% | 49,397 | 47,481 | $911K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 6.8% | 34,439 | 33,181 | $793K |
| D0272 | Bitewings - two radiographic images | 4.6% | 27,127 | 26,024 | $540K |
| D1110 | Prophylaxis - adult | 4.4% | 11,757 | 11,296 | $517K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 3.9% | 6,458 | 4,152 | $457K |
| D0230 | Intraoral - periapical each additional radiographic image | 3.1% | 45,092 | 18,001 | $360K |
| D0330 | Panoramic radiographic image | 2.9% | 8,032 | 7,700 | $341K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.9% | 11,288 | 10,780 | $335K |
| D0220 | Intraoral - periapical first radiographic image | 2.6% | 25,333 | 24,036 | $309K |
27 more codes
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 2.6% | 11,904 | $309K |
| D0274 | Bitewings - four radiographic images | 2.5% | 10,366 | $286K |
| D7140 | Extraction, erupted tooth or exposed root | 2.3% | 3,165 | $272K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 2.3% | 3,526 | $268K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 2.2% | 4,689 | $253K |
| D2934 | 1.2% | 1,098 | $140K | |
| D2150 | Silver amalgam - two surfaces, primary or permanent | <1% | 2,161 | $115K |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 3,631 | $108K |
| D0140 | Limited oral evaluation - problem focused | <1% | 3,518 | $104K |
| D2140 | <1% | 1,140 | $48K | |
| D0273 | <1% | 1,468 | $33K | |
| D9920 | <1% | 684 | $27K | |
| D1510 | <1% | 83 | $14K | |
| D9219 | <1% | 363 | $5K | |
| D0270 | <1% | 346 | $5K | |
| D2330 | <1% | 44 | $3K | |
| D2160 | <1% | 36 | $1K | |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 15 | $1K |
| D0240 | <1% | 16 | $326.72 | |
| D0350 | <1% | 7,285 | $28.41 | |
| D1330 | <1% | 50,149 | $16.04 | |
| D0603 | 0% | 34,060 | $0.00 | |
| D0602 | 0% | 1,292 | $0.00 | |
| D0601 | 0% | 12,643 | $0.00 | |
| D1353 | 0% | 2,248 | $0.00 | |
| D7111 | 0% | 37 | $0.00 | |
| D1999 | 0% | 5,828 | $0.00 |
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 officialURBANOZO, SHAUN (CREDENTIALING MANAGER)
| Provider | Location | Paid |
|---|---|---|
| Misner Dental Corp | Huntington Park, CA | $21.95M |
| Academy Kids Dental Center PC | Colorado Springs, CO | $20.71M |
| Hero Dental of Denver PC | Denver, CO | $20.64M |
| Hero Dental of Washington DC PC | Washington, DC | $19.23M |
| Captain Smiles of Greeley PC | Greeley, CO | $18.75M |
| Twin Lakes Dental PA | Wichita, KS | $16.74M |
| Montano DDS Dental Center PC | Baltimore, MD | $16.50M |
| Hero Vision of Greeley LLC | Greeley, CO | $15.43M |
| Hero Dental of Landover Hills PC - Ronald B Montano DDS | Landover Hills, MD | $14.45M |
| Hero Dental of Aurora PC | Aurora, CO | $13.98M |
| Hero Dental of Springs PC | Colorado Springs, CO | $13.58M |
| Hero Dental of Albuquerque PC | Albuquerque, NM | $13.55M |
| Ronald B Montano DDS PC | Baltimore, MD | $12.21M |
| Hero Vision of Longmont, LLC | Longmont, CO | $11.88M |
| Hero Dental of Washington DC PC | Washington, DC | $11.68M |
| R. Misner Dental Corporation | Glendale, CA | $10.86M |
| Parklane Dental PA | Wichita, KS | $10.35M |
| Hero Dental of Springs PC | Colorado Springs, CO | $9.33M |
| Pediatric Dental Group II, LLC | Tulsa, OK | $8.51M |
| Hero Dental of Santa Fe PC | Santa Fe, NM | $8.35M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.