Setaputri, Zane

Setaputri, Zane was paid $11K by Medicaid between Aug 2018 and Sep 2018, across 10 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 19% of everything it billed.

33Billing provider infoSETAPUTRI, ZANE
HUDSONVILLE, MI 49426

33aNPI1346778776assigned 05/30/2017

33bProvider typeGeneral Practice Dentistry

28Total paid$11K

24GClaims312

24DCodes billed10

24AFirst – last monthAug 2018 – Sep 2018

Compared with peers

Next to other General Practice Dentistry providers in Michigan

Rank by total paid#836 of 1,554

Median peer was paid$15K

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	312	$11K

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%	17	14	$2K
D2391	Resin-based composite - one surface, posterior, primary or permanent	16%	19	15	$2K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	14%	57	57	$1K
D1120	Dental cleaning, childProphylaxis - child	14%	37	37	$1K
D1110	Prophylaxis - adult	11%	24	24	$1K
D1206	Topical application of fluoride varnish	7.4%	31	31	$775.00
D0274	Bitewings - four radiographic images	7.1%	24	24	$747.73
D0220	Intraoral - periapical first radiographic image	6.6%	53	53	$692.92
D1208	Topical application of fluoride, excluding varnish	3.1%	15	15	$325.56
D0230	Intraoral - periapical each additional radiographic image	2.6%	35	35	$277.58

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.