Dental
Out of This World Dentistry PC
Out of This World Dentistry PC was paid $225K by Medicaid between Jan 2018 and Nov 2024, across 11 billing codes. Its largest line is D0120, dental checkup, returning patient — 72% of everything it billed.
33Billing provider infoOUT OF THIS WORLD DENTISTRY PC
DRAPER, UT 84020
DRAPER, UT 84020
33aNPI1558760959assigned 08/21/2014
33bProvider typePediatric Dentist
28Total paid$225K
24GClaims8,362
24DCodes billed11
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Pediatric Dentist providers in Utah
Rank by total paid#87 of 152
Median peer was paid$311K
This provider vs. median0.7×
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 | 280 | $8K | |
| 2019 | 739 | $21K | |
| 2020 | 497 | $19K | |
| 2021 | 1,751 | $49K | |
| 2022 | 2,332 | $60K | |
| 2023 | 1,608 | $39K | |
| 2024incomplete | 1,155 | $29K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 72% | 1,820 | 1,803 | $162K |
| D1120 | Dental cleaning, childProphylaxis - child | 9.5% | 1,704 | 1,696 | $21K |
| D1206 | Topical application of fluoride varnish | 5.2% | 1,846 | 1,835 | $12K |
| D0220 | Intraoral - periapical first radiographic image | 3.4% | 1,023 | 1,010 | $8K |
| D0272 | Bitewings - two radiographic images | 3.3% | 756 | 751 | $7K |
| D0230 | Intraoral - periapical each additional radiographic image | 2.6% | 1,008 | 874 | $6K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 2.0% | 53 | 26 | $4K |
| D2150 | Silver amalgam - two surfaces, primary or permanent | <1% | 27 | 15 | $2K |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 12 | 12 | $1K |
| D0274 | Bitewings - four radiographic images | <1% | 85 | 85 | $1K |
| D1110 | Prophylaxis - adult | 0% | 28 | 28 | $0.00 |
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 officialSTARK, DANNIELLE (OFFICE MANAGER)
| Provider | Location | Paid |
|---|---|---|
| Out of This World Dentistry WJ PC | West Jordan, UT | $783K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.