Cancelada, Antoinette

Cancelada, Antoinette was paid $3K by Medicaid between Jul 2018 and Jan 2020, across 6 billing codes. Its largest line is D1120, dental cleaning, child — 31% of everything it billed.

33Billing provider infoCANCELADA, ANTOINETTE
SAINT MARYS, KS 66536

33aNPI1942559224assigned 09/03/2012

33bProvider typeGeneral Practice Dentistry

28Total paid$3K

24GClaims190

24DCodes billed6

24AFirst – last monthJul 2018 – Jan 2020

Compared with peers

Next to other General Practice Dentistry providers in Kansas

Rank by total paid#157 of 203

Median peer was paid$40K

This provider vs. median0.1×

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
2018	66	$1K
2019	92	$1K
2020	32	$745.18

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1120	Dental cleaning, childProphylaxis - child	31%	52	46	$988.80
D0150	Comprehensive oral evaluation - new or established patient	25%	41	29	$783.00
D0274	Bitewings - four radiographic images	17%	31	26	$531.00
D1208	Topical application of fluoride, excluding varnish	14%	36	32	$442.00
D0272	Bitewings - two radiographic images	7.5%	12	12	$236.38
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	5.3%	18	14	$168.00

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.