Dental
Portage Pediatric Dentistry PLC
Portage Pediatric Dentistry PLC was paid $1.71M by Medicaid between Jan 2018 and Mar 2024, across 20 billing codes. Its largest line is D1120, dental cleaning, child — 24% of everything it billed.
33Billing provider infoPORTAGE PEDIATRIC DENTISTRY PLC
PORTAGE, MI 49002
PORTAGE, MI 49002
33aNPI1366817827assigned 12/09/2015
33bProvider typePediatric Dentist
28Total paid$1.71M
24GClaims43,492
24DCodes billed20
24AFirst – last monthJan 2018 – Mar 2024
Compared with peers
Next to other Pediatric Dentist providers in Michigan
Rank by total paid#39 of 153
Median peer was paid$464K
This provider vs. median3.7×
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 | 7,329 | $292K | |
| 2019 | 6,808 | $232K | |
| 2020 | 6,877 | $311K | |
| 2021 | 8,939 | $377K | |
| 2022 | 6,370 | $226K | |
| 2023 | 6,159 | $230K | |
| 2024incomplete | 1,010 | $42K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 24% | 10,224 | 10,219 | $402K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 17% | 9,109 | 9,104 | $286K |
| D1206 | Topical application of fluoride varnish | 16% | 10,628 | 10,622 | $280K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 9.9% | 903 | 364 | $169K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 8.0% | 1,229 | 788 | $137K |
| D0272 | Bitewings - two radiographic images | 5.4% | 3,763 | 3,761 | $92K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 4.3% | 809 | 567 | $73K |
| D1110 | Prophylaxis - adult | 3.3% | 1,085 | 1,085 | $56K |
| D7140 | Extraction, erupted tooth or exposed root | 2.8% | 597 | 350 | $48K |
| D1351 | Sealant - per tooth | 2.8% | 1,626 | 522 | $48K |
| D0140 | Limited oral evaluation - problem focused | 2.6% | 772 | 767 | $44K |
| D0220 | Intraoral - periapical first radiographic image | 2.3% | 2,209 | 2,189 | $39K |
8 more codes
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | <1% | 101 | $13K |
| D9420 | <1% | 53 | $7K | |
| D0330 | Panoramic radiographic image | <1% | 88 | $6K |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 204 | $3K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 12 | $2K |
| D0240 | <1% | 42 | $880.00 | |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 25 | $827.08 |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 13 | $578.48 |
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 officialWRATHALL, JODY (OWNER)