OUT OF THIS WORLD DENTISTRY WJ PC
NPI: 1336548841
· WEST JORDAN, UT 84084
· Pediatric Dentist
· NPI assigned 08/20/2014
$783K
Total Medicaid Paid
Provider Details
| Authorized Official | STARK, DANNIELLE (OFFICE MANAGER) |
| Parent Organization | OUT OF THIS WORLD DENTISTRY PC |
| NPI Enumeration Date | 08/20/2014 |
Related Entities
Other providers sharing the same authorized official: STARK, DANNIELLE
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
5,461 |
$148K |
| 2019 |
2,037 |
$45K |
| 2020 |
1,320 |
$44K |
| 2021 |
4,501 |
$141K |
| 2022 |
6,536 |
$171K |
| 2023 |
4,104 |
$129K |
| 2024 |
3,631 |
$104K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
|
4,879 |
4,852 |
$400K |
| D2150 |
|
849 |
395 |
$64K |
| D1120 |
|
4,831 |
4,809 |
$58K |
| D2392 |
|
438 |
191 |
$42K |
| D1351 |
|
1,318 |
304 |
$39K |
| D2140 |
|
566 |
298 |
$34K |
| D1206 |
|
5,052 |
5,028 |
$27K |
| D0150 |
|
274 |
266 |
$22K |
| D0220 |
|
2,917 |
2,842 |
$20K |
| D2391 |
|
257 |
139 |
$18K |
| D0272 |
|
2,417 |
2,401 |
$18K |
| D0230 |
|
2,631 |
2,430 |
$15K |
| D0274 |
|
803 |
792 |
$15K |
| D7140 |
|
79 |
38 |
$4K |
| D0330 |
|
84 |
83 |
$3K |
| D1110 |
|
169 |
158 |
$2K |
| D0140 |
|
13 |
13 |
$344.10 |
| D9248 |
|
13 |
12 |
$251.37 |