Dental
4TH Street Dental, PLLC
4TH Street Dental, PLLC was paid $2.65M by Medicaid between Aug 2018 and Dec 2024, across 30 billing codes. Its largest line is D0145, Oral evaluation for a patient under three years of age — 16% of everything it billed.
33Billing provider info4TH STREET DENTAL, PLLC
LUBBOCK, TX 79416
LUBBOCK, TX 79416
33aNPI1306347711assigned 02/22/2018
33bProvider typeGeneral Practice Dentistry
28Total paid$2.65M
24GClaims98,880
24DCodes billed30
24AFirst – last monthAug 2018 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in Texas
Rank by total paid#132 of 2,774
Median peer was paid$43K
This provider vs. median62×
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 | |
|---|---|---|---|
| 2018 | 165 | $4K | |
| 2020 | 3,131 | $71K | |
| 2021 | 27,965 | $794K | |
| 2022 | 30,672 | $858K | |
| 2023 | 20,507 | $481K | |
| 2024incomplete | 16,440 | $438K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0145 | Oral evaluation for a patient under three years of age | 16% | 3,193 | 3,125 | $425K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 13% | 3,814 | 1,214 | $341K |
| D1351 | Sealant - per tooth | 11% | 12,003 | 1,586 | $286K |
| D1120 | Dental cleaning, childProphylaxis - child | 8.3% | 6,645 | 6,377 | $220K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 7.6% | 1,542 | 338 | $201K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 7.6% | 7,594 | 7,264 | $200K |
| D0230 | Intraoral - periapical each additional radiographic image | 6.0% | 15,940 | 7,877 | $160K |
| D1110 | Prophylaxis - adult | 4.9% | 2,716 | 2,566 | $130K |
| D1208 | Topical application of fluoride, excluding varnish | 4.7% | 9,494 | 9,050 | $125K |
| D0220 | Intraoral - periapical first radiographic image | 3.6% | 9,068 | 8,454 | $96K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 3.1% | 1,134 | 506 | $82K |
| D0274 | Bitewings - four radiographic images | 3.0% | 2,753 | 2,604 | $80K |
18 more codes
| D0272 | Bitewings - two radiographic images | 2.9% | 4,285 | $76K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.5% | 2,239 | $67K |
| D0330 | Panoramic radiographic image | 1.5% | 1,493 | $39K |
| D9248 | 1.2% | 316 | $32K | |
| D7240 | Removal of impacted tooth - completely bony | 1.1% | 114 | $30K |
| D0210 | Intraoral - complete series of radiographic images | <1% | 467 | $26K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | <1% | 90 | $7K |
| D2335 | <1% | 50 | $6K | |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | <1% | 193 | $5K |
| D0140 | Limited oral evaluation - problem focused | <1% | 289 | $5K |
| D9222 | <1% | 60 | $3K | |
| D9223 | Deep sedation/general anesthesia - each subsequent 15 minute increment | <1% | 61 | $2K |
| D4341 | <1% | 165 | $1K | |
| D9610 | <1% | 28 | $358.38 | |
| D9310 | <1% | 12 | $192.48 | |
| D0160 | <1% | 12 | $176.42 | |
| D4355 | <1% | 13 | $71.66 | |
| D0603 | 0% | 13,097 | $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 officialCOPELAND, CRIAG (OWNER/DMD)