Oak Mountain Dental PLLC

Oak Mountain Dental PLLC was paid $72K by Medicaid between Jan 2018 and Aug 2022, across 11 billing codes. Its largest line is D1110, Prophylaxis - adult — 85% of everything it billed.

33Billing provider infoOAK MOUNTAIN DENTAL PLLC
POCATELLO, ID 83201

33aNPI1861837478assigned 05/09/2013

33bProvider typeDentist

28Total paid$72K

24GClaims3,610

24DCodes billed11

24AFirst – last monthJan 2018 – Aug 2022

Compared with peers

Next to other Dentist providers in Idaho

Rank by total paid#24 of 89

Median peer was paid$16K

This provider vs. median4.6×

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	834	$16K
2019	609	$13K
2020	459	$12K
2021	1,011	$17K
2022	697	$13K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1110	Prophylaxis - adult	85%	937	929	$61K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	9.4%	141	80	$7K
D0274	Bitewings - four radiographic images	1.8%	298	298	$1K
D0140	Limited oral evaluation - problem focused	1.7%	94	92	$1K
D1120	Dental cleaning, childProphylaxis - child	<1%	13	13	$666.05
D1206	Topical application of fluoride varnish	<1%	349	347	$282.76
D0150	Comprehensive oral evaluation - new or established patient	<1%	12	12	$172.98
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	<1%	1,075	1,072	$143.03
D0220	Intraoral - periapical first radiographic image	<1%	410	396	$26.11
D0230	Intraoral - periapical each additional radiographic image	0%	132	72	$0.00
D1208	Topical application of fluoride, excluding varnish	0%	149	147	$-98.29

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 officialRICHARDS, JAKE (DENTIST)