Custom Dental of Atoka PLLC

Custom Dental of Atoka PLLC was paid $94K by Medicaid between Jan 2018 and Oct 2024, across 6 billing codes. Its largest line is D0120, dental checkup, returning patient — 26% of everything it billed.

33Billing provider infoCUSTOM DENTAL OF ATOKA PLLC
ATOKA, OK 74525

33aNPI1730319211assigned 07/20/2009

33bProvider typeGeneral Practice Dentistry

28Total paid$94K

24GClaims3,434

24DCodes billed6

24AFirst – last monthJan 2018 – Oct 2024

Compared with peers

Next to other General Practice Dentistry providers in Oklahoma

Rank by total paid#159 of 284

Median peer was paid$172K

This provider vs. median0.5×

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	924	$27K
2019	741	$20K
2020	659	$18K
2021	370	$9K
2022	383	$11K
2023	207	$5K
2024incomplete	150	$4K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	26%	1,296	1,284	$25K
D1110	Prophylaxis - adult	24%	548	542	$23K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	18%	202	125	$17K
D1120	Dental cleaning, childProphylaxis - child	12%	421	421	$11K
D0274	Bitewings - four radiographic images	11%	360	360	$10K
D1208	Topical application of fluoride, excluding varnish	9.0%	607	607	$8K

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 officialHOOKOM, MATHEW (DENTIST)