Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
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DENTAL DEPOT OF INDEPENDENCE, PLLC

NPI: 1568193449 · INDEPENDENCE, MO 64056 · Dental Clinic/Center · NPI assigned 06/21/2022

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official ZISSA, GAYLON controls 13+ related entities in our dataset. Read more

$6K
Total Medicaid Paid
332
Total Claims
242
Beneficiaries
6
Codes Billed
2023-08
First Month
2024-08
Last Month

Provider Details

Authorized OfficialZISSA, GAYLON (DIRECTOR OF PROVIDER RELATIONS)
NPI Enumeration Date06/21/2022

Related Entities

Other providers sharing the same authorized official: ZISSA, GAYLON

ProviderCityStateTotal Paid
DENTAL DEPOT SOUTH OKLAHOMA CITY OK $3.40M
DENTAL DEPOT ORTHODONTICS CENTRAL OKC PLLC OKLAHOMA CITY OK $3.31M
DENTAL DEPOT ORTHODONTICS SOUTH PLLC OKLAHOMA CITY OK $2.53M
DENTAL DEPOT OF I-44 & GARNETT, PLLC TULSA OK $1.34M
DENTAL DEPOT ORTHODONTICS NORTH OKC PLLC OKLAHOMA CITY OK $1.22M
DENTAL DEPOT ORTHODONTICS YUKON PLLC YUKON OK $1.04M
DENTAL DEPOT OF 164TH & PORTLAND PLLC OKLAHOMA CITY OK $546K
DENTAL DEPOT OF DEL CITY, PLLC DEL CITY OK $438K
DENTAL DEPOT ORTHODONTICS TECUMSEH, PLLC NORMAN OK $107K
DENTAL DEPOT OF ARLINGTON PLLC ARLINGTON TX $31K
DENTAL DEPOT ORTHODONTICS DEL CITY, PLLC DEL CITY OK $21K
DENTAL DEPOT OF BLUE SPRINGS PLLC BLUE SPRINGS MO $21K
DENTAL DEPOT OF MUSTANG, PLLC OKLAHOMA CITY OK $5K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2023 136 $2K
2024 196 $3K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0330 Panoramic radiographic image 32 30 $1K
D0274 Bitewings - four radiographic images 48 41 $1K
D0230 Intraoral - periapical each additional radiographic image 94 47 $990.80
D0220 Intraoral - periapical first radiographic image 112 82 $889.00
D0150 Comprehensive oral evaluation - new or established patient 29 27 $832.00
D1110 Prophylaxis - adult 17 15 $437.60