Dental
My Pediatric Dentist West Maple PC
My Pediatric Dentist West Maple PC was paid $61K by Medicaid between Jul 2024 and Dec 2024, across 11 billing codes. Its largest line is D1206, Topical application of fluoride varnish — 21% of everything it billed.
33Billing provider infoMY PEDIATRIC DENTIST WEST MAPLE PC
OMAHA, NE 68164
OMAHA, NE 68164
33aNPI1033961982assigned 04/03/2024
33bProvider typePediatric Dentist
28Total paid$61K
24GClaims2,332
24DCodes billed11
24AFirst – last monthJul 2024 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Nebraska
Rank by total paid#36 of 52
Median peer was paid$292K
This provider vs. median0.2×
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 | |
|---|---|---|---|
| 2024incomplete | 2,332 | $61K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1206 | Topical application of fluoride varnish | 21% | 494 | 479 | $13K |
| D1120 | Dental cleaning, childProphylaxis - child | 21% | 381 | 372 | $13K |
| D0150 | Comprehensive oral evaluation - new or established patient | 21% | 444 | 433 | $13K |
| D0330 | Panoramic radiographic image | 15% | 216 | 210 | $9K |
| D0272 | Bitewings - two radiographic images | 5.8% | 214 | 207 | $4K |
| D1110 | Prophylaxis - adult | 5.1% | 83 | 78 | $3K |
| D0274 | Bitewings - four radiographic images | 4.0% | 111 | 106 | $2K |
| D0220 | Intraoral - periapical first radiographic image | 2.1% | 167 | 158 | $1K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 1.9% | 34 | 31 | $1K |
| D0230 | Intraoral - periapical each additional radiographic image | 1.7% | 173 | 123 | $1K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | <1% | 15 | 13 | $357.24 |
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 officialHAJEK, RYAN (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Ryan T Hajek DDS PC | Council Bluffs, IA | $5.54M |
| Pediatric Dental Group, PC | Bellevue, NE | $780K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.