Mountain City Dental, LLC

Mountain City Dental, LLC was paid $76K by Medicaid between Jun 2018 and Feb 2022, across 7 billing codes. Its largest line is D1120, dental cleaning, child — 34% of everything it billed.

33Billing provider infoMOUNTAIN CITY DENTAL, LLC
FROSTBURG, MD 21532

33aNPI1396249959assigned 03/20/2018

33bProvider typeDentist

28Total paid$76K

24GClaims2,724

24DCodes billed7

24AFirst – last monthJun 2018 – Feb 2022

Compared with peers

Next to other Dentist providers in Maryland

Rank by total paid#178 of 415

Median peer was paid$47K

This provider vs. median1.6×

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	455	$14K
2019	675	$18K
2020	667	$19K
2021	868	$24K
2022	59	$2K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1120	Dental cleaning, childProphylaxis - child	34%	655	640	$26K
D1206	Topical application of fluoride varnish	30%	969	954	$23K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	28%	768	757	$21K
D1110	Prophylaxis - adult	4.7%	66	65	$4K
D1330		1.9%	241	237	$1K
D0150	Comprehensive oral evaluation - new or established patient	<1%	13	13	$669.50
D0274	Bitewings - four radiographic images	<1%	12	12	$242.00

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 officialHOBEL, JORDAN (OWNER)