Dental
Dental Depot Hefner Station
Dental Depot Hefner Station was paid $2.78M by Medicaid between Oct 2021 and Dec 2024, across 25 billing codes. Its largest line is D2393, Resin-based composite - three surfaces, posterior, primary or permanent — 15% of everything it billed.
33Billing provider infoDENTAL DEPOT HEFNER STATION
OKLAHOMA CITY, OK 73162
OKLAHOMA CITY, OK 73162
33aNPI1528262441assigned 06/13/2007
33bProvider typeGeneral Practice Dentistry
28Total paid$2.78M
24GClaims85,031
24DCodes billed25
24AFirst – last monthOct 2021 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in Oklahoma
Rank by total paid#25 of 284
Median peer was paid$172K
This provider vs. median16×
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 | |
|---|---|---|---|
| 2021 | 4,795 | $158K | |
| 2022 | 27,589 | $888K | |
| 2023 | 25,623 | $854K | |
| 2024incomplete | 27,024 | $882K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 15% | 2,797 | 1,698 | $417K |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 14% | 3,074 | 1,153 | $376K |
| D1110 | Prophylaxis - adult | 8.6% | 5,400 | 5,210 | $238K |
| D0274 | Bitewings - four radiographic images | 7.9% | 7,413 | 7,215 | $221K |
| D0330 | Panoramic radiographic image | 7.4% | 4,309 | 4,095 | $207K |
| D0220 | Intraoral - periapical first radiographic image | 7.2% | 13,638 | 12,962 | $199K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 5.7% | 1,558 | 1,061 | $157K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 5.6% | 7,661 | 7,392 | $157K |
| D1120 | Dental cleaning, childProphylaxis - child | 5.5% | 5,138 | 4,907 | $152K |
| D2394 | 4.6% | 794 | 555 | $129K | |
| D0230 | Intraoral - periapical each additional radiographic image | 4.4% | 16,324 | 12,018 | $122K |
| D0150 | Comprehensive oral evaluation - new or established patient | 3.9% | 3,558 | 3,337 | $109K |
13 more codes
| D1206 | Topical application of fluoride varnish | 3.8% | 5,778 | $104K |
| D0140 | Limited oral evaluation - problem focused | 2.5% | 2,374 | $69K |
| D1208 | Topical application of fluoride, excluding varnish | 1.8% | 3,506 | $51K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | <1% | 663 | $18K |
| D4341 | <1% | 106 | $17K | |
| D5214 | <1% | 12 | $11K | |
| D5213 | <1% | 12 | $11K | |
| D2335 | <1% | 56 | $6K | |
| D0601 | <1% | 591 | $5K | |
| D0210 | Intraoral - complete series of radiographic images | <1% | 154 | $2K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 34 | $2K |
| D3120 | <1% | 27 | $823.23 | |
| D0602 | <1% | 54 | $494.10 |
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 officialHOLDSCLEW, ADRIENNE (OFFICE MANAGER)