Mastellotto, Mark

Mastellotto, Mark was paid $40K by Medicaid between Jan 2018 and Dec 2022, across 5 billing codes. Its largest line is D0120, dental checkup, returning patient — 39% of everything it billed.

33Billing provider infoMASTELLOTTO, MARK
ADRIAN, MI 49221

33aNPI1013077601assigned 12/12/2006

33bProvider typeDentist

28Total paid$40K

24GClaims1,627

24DCodes billed5

24AFirst – last monthJan 2018 – Dec 2022

Compared with peers

Next to other Dentist providers in Michigan

Rank by total paid#381 of 1,033

Median peer was paid$15K

This provider vs. median2.7×

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	423	$10K
2019	345	$8K
2020	258	$6K
2021	310	$8K
2022	291	$8K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	39%	649	649	$16K
D1120	Dental cleaning, childProphylaxis - child	30%	334	334	$12K
D1208	Topical application of fluoride, excluding varnish	26%	505	505	$11K
D0220	Intraoral - periapical first radiographic image	3.1%	82	82	$1K
D0230	Intraoral - periapical each additional radiographic image	1.1%	57	51	$461.79

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.