Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Dental Depot 91ST & Indian School, PLLC

Dental Depot 91ST & Indian School, PLLC was paid $17K by Medicaid between Mar 2024 and Dec 2024, across 8 billing codes. Its largest line is D0230, Intraoral - periapical each additional radiographic image — 27% of everything it billed.

33Billing provider infoDENTAL DEPOT 91ST & INDIAN SCHOOL, PLLC
PHOENIX, AZ 85037
33aNPI1073204012assigned 05/19/2023
28Total paid$17K
24GClaims1,820
24DCodes billed8
24AFirst – last monthMar 2024 – Dec 2024
Compared with peers

Next to other General Practice Dentistry providers in Arizona

Rank by total paid#142 of 530
Median peer was paid$920.17
This provider vs. median19×

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 ASHMORE, GLENN controls 20+ related entities in our dataset. Read more
Box 24A · Dates of service

Paid by month

$0$2.0K$4.0K2018201920202021202220232024
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
YearClaimsPaid
2024incomplete1,820$17K
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
D0230 Intraoral - periapical each additional radiographic image 27% 1,094 172 $5K
D0330 Panoramic radiographic image 22% 142 119 $4K
D0150 Comprehensive oral evaluation - new or established patient 13% 88 80 $2K
D0220 Intraoral - periapical first radiographic image 12% 256 196 $2K
D0274 Bitewings - four radiographic images 12% 109 92 $2K
D1206 Topical application of fluoride varnish 8.9% 95 88 $2K
D0140 Limited oral evaluation - problem focused 2.8% 18 16 $495.88
D1120 Dental cleaning, childProphylaxis - child 1.4% 18 13 $242.64

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 officialASHMORE, GLENN (OWNER / CEO)
Same official

Other billing entities under ASHMORE, GLENN

Full network →

Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.