Medicaid Provider Spending

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

COUNTRY CLUB DENTAL PA

NPI: 1699137109 · TOPEKA, KS 66611 · General Practice Dentistry · NPI assigned 03/23/2016

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

Authorized official URBANOZO, SHAUN controls 20+ related entities in our dataset. Read more

$11.68M
Total Medicaid Paid
527,959
Total Claims
380,547
Beneficiaries
39
Codes Billed
2018-01
First Month
2024-11
Last Month

Provider Details

Authorized OfficialURBANOZO, SHAUN (CREDENTIALING MANAGER)
NPI Enumeration Date03/23/2016

Related Entities

Other providers sharing the same authorized official: URBANOZO, SHAUN

ProviderCityStateTotal 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

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal 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
2024 89,559 $2.12M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1351 Sealant - per tooth 101,346 20,106 $2.56M
D2930 Prefabricated stainless steel crown - primary tooth 13,988 4,799 $1.53M
D1120 Prophylaxis - child 31,907 30,693 $1.03M
D1206 Topical application of fluoride varnish 49,397 47,481 $911K
D0120 Periodic oral evaluation - established patient 34,439 33,181 $793K
D0272 Bitewings - two radiographic images 27,127 26,024 $540K
D1110 Prophylaxis - adult 11,757 11,296 $517K
D2391 Resin-based composite - one surface, posterior, primary or permanent 6,458 4,152 $457K
D0230 Intraoral - periapical each additional radiographic image 45,092 18,001 $360K
D0330 Panoramic radiographic image 8,032 7,700 $341K
D0150 Comprehensive oral evaluation - new or established patient 11,288 10,780 $335K
D0220 Intraoral - periapical first radiographic image 25,333 24,036 $309K
D9230 Inhalation of nitrous oxide / analgesia, anxiolysis 11,904 10,134 $309K
D0274 Bitewings - four radiographic images 10,366 9,902 $286K
D7140 Extraction, erupted tooth or exposed root 3,165 1,958 $272K
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 3,526 2,317 $268K
D3220 Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction 4,689 1,919 $253K
D2934 1,098 349 $140K
D2150 Silver amalgam - two surfaces, primary or permanent 2,161 1,212 $115K
D0145 Oral evaluation for a patient under three years of age 3,631 3,516 $108K
D0140 Limited oral evaluation - problem focused 3,518 3,345 $104K
D2140 1,140 637 $48K
D0273 1,468 1,420 $33K
D9920 684 592 $27K
D1510 83 58 $14K
D9219 363 288 $5K
D0270 346 337 $5K
D2330 44 31 $3K
D2160 36 12 $1K
D2393 Resin-based composite - three surfaces, posterior, primary or permanent 15 12 $1K
D0240 16 16 $326.72
D0350 7,285 3,724 $28.41
D1330 50,149 48,186 $16.04
D0603 34,060 32,691 $0.00
D0602 1,292 1,258 $0.00
D0601 12,643 12,221 $0.00
D1353 2,248 851 $0.00
D7111 37 25 $0.00
D1999 5,828 5,287 $0.00