Dental
Dental Depot Mid West City
Dental Depot Mid West City was paid $3.88M by Medicaid between Oct 2021 and Dec 2024, across 36 billing codes. Its largest line is D7210, Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth — 25% of everything it billed.
33Billing provider infoDENTAL DEPOT MID WEST CITY
MIDWEST CITY, OK 73110
MIDWEST CITY, OK 73110
33aNPI1245434166assigned 06/13/2007
33bProvider typeGeneral Practice Dentistry
28Total paid$3.88M
24GClaims113,844
24DCodes billed36
24AFirst – last monthOct 2021 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in Oklahoma
Rank by total paid#16 of 284
Median peer was paid$172K
This provider vs. median23×
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 | 9,587 | $285K | |
| 2022 | 37,606 | $1.20M | |
| 2023 | 34,888 | $1.26M | |
| 2024incomplete | 31,763 | $1.14M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 25% | 7,948 | 2,450 | $973K |
| D1110 | Prophylaxis - adult | 8.1% | 7,100 | 6,795 | $314K |
| D0330 | Panoramic radiographic image | 7.4% | 6,010 | 5,654 | $288K |
| D0274 | Bitewings - four radiographic images | 7.2% | 9,416 | 9,192 | $280K |
| D0220 | Intraoral - periapical first radiographic image | 6.9% | 18,314 | 17,434 | $270K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 6.3% | 1,601 | 1,152 | $246K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 5.9% | 2,029 | 1,418 | $229K |
| D1120 | Dental cleaning, childProphylaxis - child | 5.5% | 7,125 | 6,883 | $212K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 5.3% | 10,002 | 9,651 | $207K |
| D0230 | Intraoral - periapical each additional radiographic image | 3.8% | 19,579 | 15,547 | $146K |
| D0150 | Comprehensive oral evaluation - new or established patient | 3.6% | 4,655 | 4,485 | $141K |
| D1206 | Topical application of fluoride varnish | 3.3% | 7,048 | 6,532 | $128K |
24 more codes
| D0140 | Limited oral evaluation - problem focused | 3.1% | 4,080 | $120K |
| D1208 | Topical application of fluoride, excluding varnish | 2.1% | 5,444 | $80K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 1.2% | 1,751 | $47K |
| D5214 | 1.1% | 47 | $44K | |
| D5213 | <1% | 42 | $38K | |
| D2150 | Silver amalgam - two surfaces, primary or permanent | <1% | 373 | $35K |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 266 | $18K |
| D2394 | <1% | 76 | $12K | |
| D5130 | <1% | 14 | $11K | |
| D5140 | <1% | 13 | $10K | |
| D2140 | <1% | 103 | $6K | |
| D7310 | <1% | 46 | $5K | |
| D2332 | <1% | 43 | $5K | |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 61 | $3K |
| D5410 | <1% | 79 | $3K | |
| D0210 | Intraoral - complete series of radiographic images | <1% | 174 | $3K |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 76 | $2K |
| D2160 | <1% | 18 | $2K | |
| D5411 | <1% | 49 | $2K | |
| D0601 | <1% | 132 | $1K | |
| D0272 | Bitewings - two radiographic images | <1% | 44 | $808.46 |
| D3120 | <1% | 15 | $457.50 | |
| D0602 | <1% | 37 | $338.55 | |
| D0603 | <1% | 34 | $311.10 |
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 officialGRANT, BETH (OFFICE MANAGER)