Clinic
Northern Michigan Pediatric Dentistry
Northern Michigan Pediatric Dentistry was paid $7.05M by Medicaid between Jan 2018 and Dec 2024, across 31 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 17% of everything it billed.
33Billing provider infoNORTHERN MICHIGAN PEDIATRIC DENTISTRY
TRAVERSE CITY, MI 49684
TRAVERSE CITY, MI 49684
33aNPI1275685265assigned 01/18/2007
33bProvider typeDental Clinic/Center
28Total paid$7.05M
24GClaims141,434
24DCodes billed31
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Dental Clinic/Center providers in Michigan
Rank by total paid#3 of 431
Median peer was paid$24K
This provider vs. median292×
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 | 18,053 | $990K | |
| 2019 | 18,181 | $924K | |
| 2020 | 15,680 | $772K | |
| 2021 | 22,585 | $1.10M | |
| 2022 | 22,698 | $1.08M | |
| 2023 | 24,292 | $1.20M | |
| 2024incomplete | 19,945 | $982K |
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 | 17% | 9,967 | 6,106 | $1.19M |
| D1120 | Dental cleaning, childProphylaxis - child | 13% | 22,534 | 22,523 | $900K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 11% | 25,108 | 25,105 | $808K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 11% | 4,208 | 1,740 | $797K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 9.1% | 7,264 | 4,584 | $638K |
| D1208 | Topical application of fluoride, excluding varnish | 6.6% | 17,828 | 17,824 | $465K |
| D7140 | Extraction, erupted tooth or exposed root | 5.2% | 4,381 | 2,539 | $367K |
| D0272 | Bitewings - two radiographic images | 3.9% | 11,348 | 11,338 | $275K |
| D1206 | Topical application of fluoride varnish | 2.5% | 6,541 | 6,532 | $177K |
| D1110 | Prophylaxis - adult | 2.3% | 3,337 | 3,336 | $161K |
| D0140 | Limited oral evaluation - problem focused | 2.2% | 2,562 | 2,538 | $154K |
| D2331 | 1.9% | 1,362 | 917 | $134K |
19 more codes
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 1.7% | 832 | $121K |
| D9420 | 1.7% | 843 | $120K | |
| D2330 | 1.5% | 1,405 | $108K | |
| D1354 | 1.1% | 3,142 | $81K | |
| D1351 | Sealant - per tooth | 1.0% | 2,389 | $72K |
| D0330 | Panoramic radiographic image | <1% | 1,011 | $70K |
| D0220 | Intraoral - periapical first radiographic image | <1% | 3,391 | $62K |
| D9310 | <1% | 854 | $61K | |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 1,001 | $58K |
| D2332 | <1% | 458 | $57K | |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 3,460 | $46K |
| D0240 | <1% | 2,633 | $44K | |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | <1% | 335 | $42K |
| D2335 | <1% | 99 | $18K | |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 357 | $14K |
| D0274 | Bitewings - four radiographic images | <1% | 149 | $6K |
| D9110 | <1% | 50 | $4K | |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 0% | 2,572 | $0.00 |
| D9995 | 0% | 13 | $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 officialVAN WINGEN, JAMES (DENTIST)