TOPEKA DENTAL CLINIC, LLC

NPI: 1861449712 · TOPEKA, KS 66605 · General Practice Dentistry · NPI assigned 05/27/2006

$235K

Total Medicaid Paid

9,610

Total Claims

8,497

Beneficiaries

Codes Billed

2018-01

First Month

2018-12

Last Month

Provider Details

Authorized Official	STUMP, JENELL (DIRECTOR, LICENSING & CREDENTIALING)
NPI Enumeration Date	05/27/2006

Other providers sharing the same authorized official: STUMP, JENELL

Provider	City	State	Total Paid
AKRON SMILES YOUTH DENTISTRY LLC MICHAEL CRITES, DDS	AKRON	OH	$10.24M
THE INDIAN SPRINGS DENTAL CLINIC, LLC	KANSAS CITY	KS	$1.94M
SMALL SMILES OF WICHITA, LLC	WICHITA	KS	$576K
COMMUNITY CARE OF KENTUCKY INC.	LOUISVILLE	KY	$576K
ADVANTAGE DENTAL ORAL HEALTH CENTER OF MASSACHUSETTS, PC	WESTBOROUGH	MA	$143K
SAGER DENTAL PLLC	TEXAS CITY	TX	$57K
YOUNGSTOWN SMILES YOUTH DENTISTRY LLCMICHAEL CRITES DDS	YOUNGSTOWN	OH	$7K

Year	Claims	Total Paid
2018	9,610	$235K

Code	Description	Claims	Beneficiaries	Total Paid
D1120	Prophylaxis - child	1,391	1,383	$40K
D0120	Periodic oral evaluation - established patient	1,768	1,760	$36K
D1351	Sealant - per tooth	1,505	566	$36K
D1206	Topical application of fluoride varnish	1,993	1,984	$33K
D1110	Prophylaxis - adult	531	530	$21K
D0272	Bitewings - two radiographic images	1,049	1,046	$20K
D2391	Resin-based composite - one surface, posterior, primary or permanent	255	186	$16K
D0274	Bitewings - four radiographic images	574	572	$16K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	120	79	$8K
D9230	Inhalation of nitrous oxide / analgesia, anxiolysis	334	301	$6K
D0150	Comprehensive oral evaluation - new or established patient	54	54	$2K
D0330	Panoramic radiographic image	36	36	$1K