Mitchell Dental Clinic LLC

Mitchell Dental Clinic LLC was paid $106K by Medicaid between Jan 2018 and Nov 2024, across 7 billing codes. Its largest line is D1110, Prophylaxis - adult — 58% of everything it billed.

33Billing provider infoMITCHELL DENTAL CLINIC LLC
MITCHELL, SD 57301

33aNPI1629284401assigned 05/16/2007

33bProvider typeDentist

28Total paid$106K

24GClaims2,491

24DCodes billed7

24AFirst – last monthJan 2018 – Nov 2024

Compared with peers

Next to other Dentist providers in South Dakota

Rank by total paid#6 of 42

Median peer was paid$19K

This provider vs. median5.7×

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	354	$15K
2019	415	$18K
2020	229	$10K
2021	373	$14K
2022	398	$16K
2023	427	$18K
2024incomplete	295	$15K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1110	Prophylaxis - adult	58%	1,085	1,072	$61K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	32%	1,131	1,120	$34K
D1208	Topical application of fluoride, excluding varnish	4.7%	181	180	$5K
D9920		4.6%	46	41	$5K
D0274	Bitewings - four radiographic images	<1%	12	12	$440.16
D0220	Intraoral - periapical first radiographic image	<1%	16	16	$251.25
D0230	Intraoral - periapical each additional radiographic image	<1%	20	13	$213.29

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 officialWINTHERS, DORSAY (PARTNER)