Mpda Broken Bow LLC

Mpda Broken Bow LLC was paid $22K by Medicaid between Feb 2022 and Oct 2024, across 7 billing codes. Its largest line is D0120, dental checkup, returning patient — 42% of everything it billed.

33Billing provider infoMPDA BROKEN BOW LLC
BROKEN BOW, NE 68822

33aNPI1376294298assigned 01/12/2022

33bProvider typeGeneral Practice Dentistry

28Total paid$22K

24GClaims758

24DCodes billed7

24AFirst – last monthFeb 2022 – Oct 2024

Compared with peers

Next to other General Practice Dentistry providers in Nebraska

Rank by total paid#100 of 201

Median peer was paid$21K

This provider vs. median1.0×

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
2022	189	$5K
2023	290	$8K
2024incomplete	279	$8K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	42%	381	376	$9K
D1110	Prophylaxis - adult	28%	178	171	$6K
D1206	Topical application of fluoride varnish	13%	110	106	$3K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	9.1%	22	13	$2K
D1120	Dental cleaning, childProphylaxis - child	5.2%	42	38	$1K
D0150	Comprehensive oral evaluation - new or established patient	1.4%	12	12	$308.28
D0274	Bitewings - four radiographic images	1.3%	13	13	$288.47

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 officialLASHLEY, BENJAMIN (SOLE MEMBER)