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    OpenPayerNPI Medicare & MedicaidDental Depot Mid West City
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    Dental Depot Mid West City — Billing Profile & Reimbursement Data

    NPI 1245434166 · Midwest City, OK · General Practice Dentistry

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    Dental Depot Mid West City is a general practice dentistry provider located in Midwest City, Oklahoma. This profile covers 0 Medicare and 36 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationDental Depot Mid West City
    Address5691 Tinker Diagonal
    CityMidwest City
    StateOK
    ZIP73110
    TaxonomyGeneral Practice Dentistry
    NPI EnumeratedJune 13, 2007

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$3.9M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

    Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

    36 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    D7210Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation; includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of…7,950$120$969.7K
    D1110Prophylaxis - adult; cleaning and polishing of the teeth7,100$40$312.4K
    D0330N/A6,010$50$288.5K
    D0274N/A9,420$30$282.5K
    D0220Intraoral - periapical first radiographic image18,310$20$274.7K
    D2393Resin-based composite, three surfaces, posterior1,600$150$246.6K
    D2392Post 2 surface resin‑based composite2,030$110$229.3K
    D1120Prophylaxis–child7,130$30$213.8K
    D0120Periodic oral evaluation - established patient10,000$20$210K
    D0150Comprehensive oral evaluation – new or established patient4,660$30$139.7K

    Showing 1–10 of 36

    Medicaid: Competitive Analysis & Benchmarks

    How this provider's Medicaid billing volume and revenue compare to other Oklahoma providers billing the same CPT/HCPCS codes.

    Full comparison — all codes billed, vs. Oklahoma median

    36 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    D7210Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation; includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of…9180450$120$188.3K
    D2392Post 2 surface resin‑based composite69330530$100$162.1K
    D2393Resin-based composite, three surfaces, posterior33190300$140$128.6K
    D5214N/A82040$950$98.3K
    D7140Extraction, erupted tooth or exposed root (elevation and/or forceps removal)122240280$70$91.8K
    D5213N/A71060$960$90.8K
    D5130N/A243030$850$77.9K
    D1120Prophylaxis–child39470730$30$77.5K
    D5140N/A172020$850$74.6K
    D0120Periodic oral evaluation - established patient38540910$20$61.2K

    Showing 1–10 of 36

    Nearby Providers

    Other providers in the same ZIP code as Dental Depot Mid West City, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Midwest Regional Medical Center, LLCOKGeneral Acute Care Hospital$0$5.3M
    Ssm Health Care Of Oklahoma, IncOKGeneral Acute Care Hospital$0$4.9M
    Pediatric Dental Group Ii, LLCOKDental Clinic/Center$0$4.8M
    Shepherd's Recovery And Counseling ServicesOKCommunity/Behavioral Health Agency$0$4M
    Midwest City Hma Physician Management, LLCOKObstetrics & Gynecology Physician$0$2.4M
    Hero Vision Of Midwest City PLLCOKOptometrist$0$2M
    Midwest Regional Medical Center, LLCOKAmbulance$0$1.8M
    All About Caring Home Health Care, LLCOKHome Health Agency$0$1.6M
    Ssm Health Care Of Oklahoma, IncOKAmbulance$0$1.6M
    Jessi RunyanOKFamily Nurse Practitioner$573.8K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Oklahoma Providers
    0 of 4 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Oklahoma Distribution
    Dental Depot Mid West City — 8 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Oklahoma