Dental
Pediatric Dental Specilaist, P.C
Pediatric Dental Specilaist, P.C was paid $994K by Medicaid between Jul 2022 and Dec 2024, across 22 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 19% of everything it billed.
33Billing provider infoPEDIATRIC DENTAL SPECILAIST, P.C
PORT HURON, MI 48060
PORT HURON, MI 48060
33aNPI1255063244assigned 06/28/2022
33bProvider typePediatric Dentist
28Total paid$994K
24GClaims21,117
24DCodes billed22
24AFirst – last monthJul 2022 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Michigan
Rank by total paid#51 of 153
Median peer was paid$464K
This provider vs. median2.1×
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 | 3,122 | $147K | |
| 2023 | 9,503 | $430K | |
| 2024incomplete | 8,492 | $417K |
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 | 19% | 1,537 | 895 | $185K |
| D1120 | Dental cleaning, childProphylaxis - child | 16% | 3,597 | 3,597 | $155K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 13% | 3,726 | 3,725 | $126K |
| D1206 | Topical application of fluoride varnish | 11% | 3,823 | 3,823 | $109K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 9.4% | 1,081 | 566 | $94K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 6.2% | 413 | 317 | $61K |
| D1351 | Sealant - per tooth | 5.5% | 1,642 | 381 | $54K |
| D1110 | Prophylaxis - adult | 3.2% | 590 | 590 | $31K |
| D0210 | Intraoral - complete series of radiographic images | 3.1% | 357 | 357 | $31K |
| D0272 | Bitewings - two radiographic images | 3.1% | 1,182 | 1,182 | $30K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 2.9% | 143 | 66 | $29K |
| D0220 | Intraoral - periapical first radiographic image | 1.7% | 950 | 944 | $17K |
10 more codes
| D0150 | Comprehensive oral evaluation - new or established patient | 1.6% | 252 | $16K |
| D7140 | Extraction, erupted tooth or exposed root | 1.5% | 168 | $15K |
| D0230 | Intraoral - periapical each additional radiographic image | 1.1% | 807 | $11K |
| D0140 | Limited oral evaluation - problem focused | 1.0% | 164 | $10K |
| D1354 | <1% | 225 | $6K | |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 191 | $5K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | <1% | 29 | $4K |
| D0274 | Bitewings - four radiographic images | <1% | 78 | $3K |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 24 | $1K |
| D9986 | 0% | 138 | $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 officialWOODWARD, KACEY (RECEPTIONIST)