Dental
Hickok, Travis
Hickok, Travis was paid $120K by Medicaid between Jun 2020 and May 2021, across 15 billing codes. Its largest line is D0120, dental checkup, returning patient — 76% of everything it billed.
33Billing provider infoHICKOK, TRAVIS
SLC, UT 84132
SLC, UT 84132
33aNPI1376797944assigned 11/10/2008
33bProvider typeDentist
28Total paid$120K
24GClaims4,184
24DCodes billed15
24AFirst – last monthJun 2020 – May 2021
Compared with peers
Next to other Dentist providers in Utah
Rank by total paid#40 of 136
Median peer was paid$35K
This provider vs. median3.4×
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 | |
|---|---|---|---|
| 2020 | 1,849 | $54K | |
| 2021 | 2,335 | $66K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 76% | 888 | 888 | $92K |
| D1351 | Sealant - per tooth | 13% | 444 | 86 | $16K |
| D2140 | 2.1% | 59 | 43 | $3K | |
| D1206 | Topical application of fluoride varnish | 1.5% | 826 | 826 | $2K |
| D0272 | Bitewings - two radiographic images | 1.5% | 711 | 710 | $2K |
| D1120 | Dental cleaning, childProphylaxis - child | 1.4% | 848 | 847 | $2K |
| D2150 | Silver amalgam - two surfaces, primary or permanent | 1.3% | 17 | 12 | $2K |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.2% | 12 | 12 | $1K |
| D0140 | Limited oral evaluation - problem focused | <1% | 15 | 14 | $885.88 |
| D0220 | Intraoral - periapical first radiographic image | <1% | 157 | 156 | $470.17 |
| D1110 | Prophylaxis - adult | <1% | 48 | 48 | $115.70 |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 57 | 57 | $94.00 |
3 more codes
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.