Dental
Gustafson, Kerri
Gustafson, Kerri was paid $320K by Medicaid between Jan 2018 and Feb 2023, across 24 billing codes. Its largest line is D1120, dental cleaning, child — 24% of everything it billed.
33Billing provider infoGUSTAFSON, KERRI
ROSEVILLE, MI 48066
ROSEVILLE, MI 48066
33aNPI1316910763assigned 02/08/2006
33bProvider typePediatric Dentist
28Total paid$320K
24GClaims10,887
24DCodes billed24
24AFirst – last monthJan 2018 – Feb 2023
Compared with peers
Next to other Pediatric Dentist providers in Michigan
Rank by total paid#86 of 153
Median peer was paid$464K
This provider vs. median0.7×
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 | 3,033 | $106K | |
| 2019 | 2,855 | $98K | |
| 2020 | 612 | $19K | |
| 2022 | 2,826 | $61K | |
| 2023 | 1,561 | $36K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 24% | 1,905 | 1,901 | $75K |
| D0140 | Limited oral evaluation - problem focused | 16% | 851 | 844 | $50K |
| D1206 | Topical application of fluoride varnish | 15% | 2,086 | 2,082 | $49K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 14% | 1,522 | 1,522 | $46K |
| D0272 | Bitewings - two radiographic images | 6.5% | 898 | 898 | $21K |
| D0150 | Comprehensive oral evaluation - new or established patient | 5.4% | 353 | 351 | $17K |
| D0220 | Intraoral - periapical first radiographic image | 4.0% | 743 | 728 | $13K |
| D0230 | Intraoral - periapical each additional radiographic image | 2.8% | 712 | 387 | $9K |
| D0240 | 2.2% | 402 | 266 | $7K | |
| D1110 | Prophylaxis - adult | 2.1% | 149 | 149 | $7K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 1.3% | 22 | 12 | $4K |
| D7140 | Extraction, erupted tooth or exposed root | 1.2% | 46 | 24 | $4K |
12 more codes
| D0603 | <1% | 478 | $3K | |
| D2150 | Silver amalgam - two surfaces, primary or permanent | <1% | 22 | $2K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 39 | $2K |
| D2940 | <1% | 26 | $2K | |
| D0274 | Bitewings - four radiographic images | <1% | 70 | $2K |
| D0330 | Panoramic radiographic image | <1% | 18 | $1K |
| D0602 | <1% | 230 | $1K | |
| D9248 | <1% | 24 | $1K | |
| D0601 | <1% | 162 | $957.00 | |
| D1351 | Sealant - per tooth | <1% | 36 | $910.00 |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 29 | $756.00 |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 0% | 64 | $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.