Dental
Children's Dental Depot PA
Children's Dental Depot PA was paid $780K by Medicaid between Nov 2020 and Dec 2024, across 22 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 24% of everything it billed.
33Billing provider infoCHILDREN'S DENTAL DEPOT PA
GUN BARREL CITY, TX 75156
GUN BARREL CITY, TX 75156
33aNPI1235779109assigned 01/08/2020
33bProvider typePediatric Dentist
28Total paid$780K
24GClaims33,014
24DCodes billed22
24AFirst – last monthNov 2020 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Texas
Rank by total paid#218 of 693
Median peer was paid$252K
This provider vs. median3.1×
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 | |
|---|---|---|---|
| 2020 | 206 | $3K | |
| 2021 | 3,513 | $65K | |
| 2022 | 7,000 | $154K | |
| 2023 | 11,616 | $299K | |
| 2024incomplete | 10,679 | $259K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 24% | 1,439 | 511 | $184K |
| D0145 | Oral evaluation for a patient under three years of age | 19% | 1,133 | 1,084 | $148K |
| D1120 | Dental cleaning, childProphylaxis - child | 11% | 2,427 | 2,346 | $83K |
| D9248 | 10% | 773 | 736 | $81K | |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 6.8% | 1,941 | 1,875 | $53K |
| D0230 | Intraoral - periapical each additional radiographic image | 5.2% | 3,980 | 2,446 | $40K |
| D1206 | Topical application of fluoride varnish | 4.8% | 2,708 | 2,618 | $37K |
| D0272 | Bitewings - two radiographic images | 4.6% | 1,761 | 1,697 | $36K |
| D1351 | Sealant - per tooth | 4.4% | 1,318 | 325 | $35K |
| D0220 | Intraoral - periapical first radiographic image | 4.0% | 2,847 | 2,686 | $31K |
| D0150 | Comprehensive oral evaluation - new or established patient | 3.8% | 919 | 873 | $29K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 1.6% | 193 | 71 | $12K |
10 more codes
| D7140 | Extraction, erupted tooth or exposed root | <1% | 72 | $4K |
| D0330 | Panoramic radiographic image | <1% | 109 | $2K |
| D2150 | Silver amalgam - two surfaces, primary or permanent | <1% | 24 | $2K |
| D0274 | Bitewings - four radiographic images | <1% | 54 | $1K |
| D1110 | Prophylaxis - adult | <1% | 25 | $1K |
| D0140 | Limited oral evaluation - problem focused | <1% | 27 | $505.18 |
| D1330 | <1% | 3,757 | $12.25 | |
| D1310 | 0% | 3,155 | $0.00 | |
| D0603 | 0% | 4,319 | $0.00 | |
| D0601 | 0% | 33 | $0.00 |
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.
From NPPES
Who's on the registration
Authorized officialPLAGENS, JOLIE (BILLING AND INSURANCE COORD)