Dental
Grand River Pediatric Dentistry PLLC
Grand River Pediatric Dentistry PLLC was paid $2.99M by Medicaid between Jun 2020 and Dec 2024, across 32 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 30% of everything it billed.
33Billing provider infoGRAND RIVER PEDIATRIC DENTISTRY PLLC
JENISON, MI 49428
JENISON, MI 49428
33aNPI1174175996assigned 07/11/2019
33bProvider typePediatric Dentist
28Total paid$2.99M
24GClaims56,202
24DCodes billed32
24AFirst – last monthJun 2020 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Michigan
Rank by total paid#21 of 153
Median peer was paid$464K
This provider vs. median6.4×
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 | |
|---|---|---|---|
| 2020 | 2,951 | $167K | |
| 2021 | 10,423 | $605K | |
| 2022 | 13,613 | $731K | |
| 2023 | 15,875 | $815K | |
| 2024incomplete | 13,340 | $671K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 30% | 4,610 | 1,380 | $899K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 10% | 3,274 | 1,766 | $302K |
| D1120 | Dental cleaning, childProphylaxis - child | 8.2% | 6,081 | 6,080 | $245K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 7.7% | 1,932 | 1,170 | $229K |
| D1206 | Topical application of fluoride varnish | 5.7% | 6,355 | 6,351 | $170K |
| D7140 | Extraction, erupted tooth or exposed root | 5.3% | 1,793 | 925 | $159K |
| D1351 | Sealant - per tooth | 5.2% | 5,424 | 1,794 | $155K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 4.6% | 4,284 | 4,283 | $139K |
| D2390 | 4.0% | 585 | 195 | $119K | |
| D1354 | 3.4% | 4,256 | 1,817 | $102K | |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 2.7% | 613 | 363 | $80K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.4% | 1,460 | 1,455 | $72K |
20 more codes
| D0140 | Limited oral evaluation - problem focused | 2.0% | 1,017 | $59K |
| D0272 | Bitewings - two radiographic images | 1.8% | 3,069 | $54K |
| D0220 | Intraoral - periapical first radiographic image | 1.6% | 2,683 | $47K |
| D0240 | 1.4% | 2,041 | $41K | |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 2,264 | $29K |
| D9310 | <1% | 369 | $26K | |
| D0330 | Panoramic radiographic image | <1% | 360 | $23K |
| D0210 | Intraoral - complete series of radiographic images | <1% | 176 | $12K |
| D1510 | <1% | 35 | $7K | |
| D0274 | Bitewings - four radiographic images | <1% | 189 | $5K |
| D2330 | <1% | 49 | $4K | |
| D2331 | <1% | 33 | $3K | |
| D1110 | Prophylaxis - adult | <1% | 56 | $3K |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 71 | $3K |
| D9420 | <1% | 16 | $1K | |
| D7111 | <1% | 14 | $923.77 | |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 0% | 2,335 | $0.00 |
| D1353 | 0% | 613 | $0.00 | |
| D3120 | 0% | 108 | $0.00 | |
| D0603 | 0% | 37 | $0.00 |
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 officialCONDIT, MEGHAN (MEMBER)