NPI: 1386409001 · IRON RIVER, MI 49935 · General Practice Dentistry · NPI assigned 02/21/2024
Authorized official HODGES, TREVOR controls 14+ related entities in our dataset. Read more
| Authorized Official | HODGES, TREVOR (CEO) |
| NPI Enumeration Date | 02/21/2024 |
Other providers sharing the same authorized official: HODGES, TREVOR
| Provider | City | State | Total Paid |
|---|---|---|---|
| UPPER GREAT LAKES FAMILY HEALTH CENTER | HANCOCK | MI | $4.08M |
| UPPER GREAT LAKES FAMILY HEALTH CENTER | GWINN | MI | $1.84M |
| UPPER GREAT LAKES FAMILY HEALTH CENTER | GWINN | MI | $1.57M |
| UPPER GREAT LAKES FAMILY HEALTH CENTER | MARQUETTE | MI | $1.56M |
| UPPER GREAT LAKES FAMILY HEALTH CENTER | CALUMET | MI | $1.41M |
| UPPER GREAT LAKES FAMILY HEALTH CENTER | GWINN | MI | $1.27M |
| UPPER GREAT LAKES FAMILY HEALTH CENTER | HOUGHTON | MI | $955K |
| UPPER GREAT LAKES FAMILY HEALTH CENTER | CALUMET | MI | $947K |
| UPPER GREAT LAKES FAMILY HEALTH CENTER | LAKE LINDEN | MI | $350K |
| UPPER GREAT LAKES FAMILY HEALTH CENTER | MENOMINEE | MI | $337K |
| UPPER GREAT LAKES FAMILY HEALTH CENTER | ONTONAGON | MI | $167K |
| UPPER GREAT LAKES FAMILY HEALTH CENTER | IRON RIVER | MI | $164K |
| UPPER GREAT LAKES FAMILY HEALTH CENTER | HANCOCK | MI | $32K |
| UPPER GREAT LAKES FAMILY HEALTH CENTER | LAKE LINDEN | MI | $24K |
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 439 | $31K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D7140 | Extraction, erupted tooth or exposed root | 120 | 40 | $11K |
| D0150 | Comprehensive oral evaluation - new or established patient | 116 | 116 | $6K |
| D0210 | Intraoral - complete series of radiographic images | 69 | 69 | $5K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 25 | 12 | $3K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 17 | 12 | $2K |
| D0330 | Panoramic radiographic image | 17 | 17 | $1K |
| D1110 | Prophylaxis - adult | 18 | 18 | $1K |
| D0140 | Limited oral evaluation - problem focused | 16 | 16 | $760.00 |
| D1206 | Topical application of fluoride varnish | 16 | 16 | $270.00 |
| D0220 | Intraoral - periapical first radiographic image | 13 | 13 | $222.00 |
| D0274 | Bitewings - four radiographic images | 12 | 12 | $216.00 |