Dental
Premiere Dentistry of Tahlequah
Premiere Dentistry of Tahlequah was paid $15K by Medicaid between Nov 2021 and Dec 2021, across 9 billing codes. Its largest line is D0120, dental checkup, returning patient — 20% of everything it billed.
33Billing provider infoPREMIERE DENTISTRY OF TAHLEQUAH
TAHLEQUAH, OK 74464
TAHLEQUAH, OK 74464
33aNPI1245299825assigned 03/21/2006
33bProvider typeGeneral Practice Dentistry
28Total paid$15K
24GClaims598
24DCodes billed9
24AFirst – last monthNov 2021 – Dec 2021
Compared with peers
Next to other General Practice Dentistry providers in Oklahoma
Rank by total paid#222 of 284
Median peer was paid$172K
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 | |
|---|---|---|---|
| 2021 | 598 | $15K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 20% | 155 | 155 | $3K |
| D1120 | Dental cleaning, childProphylaxis - child | 18% | 94 | 94 | $3K |
| D1110 | Prophylaxis - adult | 17% | 60 | 60 | $3K |
| D1208 | Topical application of fluoride, excluding varnish | 16% | 167 | 167 | $2K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 13% | 21 | 13 | $2K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 5.9% | 15 | 12 | $914.70 |
| D0220 | Intraoral - periapical first radiographic image | 4.1% | 41 | 41 | $624.84 |
| D0272 | Bitewings - two radiographic images | 3.4% | 31 | 31 | $530.70 |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 2.5% | 14 | 13 | $384.16 |
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 officialJONES, ROBERT (DENTIST)
| Provider | Location | Paid |
|---|---|---|
| Georgia Pines Community Service Board | Thomasville, GA | $45.34M |
| California Anesthesia Associates Medical Group, INC. | Long Beach, CA | $3.36M |
| Southwest Integrative Health Center, LLC | Albuquerque, NM | $1.35M |
| Barbour County Emergency Squad INC. | Philippi, WV | $1.16M |
| Colorado River Fire Rescue | Rifle, CO | $358K |
| Longview Orthopaedic Center, LLC | Leominster, MA | $269K |
| Robert H Jones DDS PC | Mcminnville, TN | $39K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.