Clinic
Broken Bow Dentistry PLLC
Broken Bow Dentistry PLLC was paid $734K by Medicaid between Jan 2022 and Dec 2024, across 21 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 24% of everything it billed.
33Billing provider infoBROKEN BOW DENTISTRY PLLC
BROKEN BOW, OK 74728
BROKEN BOW, OK 74728
33aNPI1811658685assigned 01/04/2022
33bProvider typeDental Clinic/Center
28Total paid$734K
24GClaims22,407
24DCodes billed21
24AFirst – last monthJan 2022 – Dec 2024
Compared with peers
Next to other Dental Clinic/Center providers in Oklahoma
Rank by total paid#23 of 112
Median peer was paid$86K
This provider vs. median8.5×
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 | |
|---|---|---|---|
| 2022 | 7,698 | $258K | |
| 2023 | 7,104 | $236K | |
| 2024incomplete | 7,605 | $240K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 24% | 1,561 | 1,072 | $172K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 16% | 816 | 612 | $120K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 8.4% | 2,931 | 2,858 | $62K |
| D1110 | Prophylaxis - adult | 8.4% | 1,363 | 1,331 | $62K |
| D1120 | Dental cleaning, childProphylaxis - child | 8.3% | 2,000 | 1,950 | $61K |
| D0220 | Intraoral - periapical first radiographic image | 6.2% | 3,029 | 2,844 | $46K |
| D1206 | Topical application of fluoride varnish | 5.5% | 2,212 | 2,130 | $40K |
| D0330 | Panoramic radiographic image | 5.1% | 778 | 757 | $38K |
| D0274 | Bitewings - four radiographic images | 4.4% | 1,077 | 1,051 | $33K |
| D0230 | Intraoral - periapical each additional radiographic image | 2.6% | 2,554 | 2,106 | $19K |
| D1208 | Topical application of fluoride, excluding varnish | 2.4% | 1,165 | 1,165 | $18K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 2.2% | 270 | 220 | $16K |
9 more codes
| D0272 | Bitewings - two radiographic images | 1.8% | 743 | $13K |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.7% | 411 | $13K |
| D0140 | Limited oral evaluation - problem focused | 1.1% | 274 | $8K |
| D0603 | <1% | 604 | $6K | |
| D0602 | <1% | 427 | $4K | |
| D0240 | <1% | 103 | $2K | |
| D3120 | <1% | 38 | $1K | |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 26 | $793.00 |
| D0601 | <1% | 25 | $228.75 |
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 officialBARTLETT, KEITH (MANAGER)