Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › MI › DETROIT › FILL GOOD DENTAL CARE INC

FILL GOOD DENTAL CARE INC

NPI: 1417428780 · DETROIT, MI 48223 · Dental Clinic/Center · NPI assigned 12/16/2018

$6K
Total Medicaid Paid
190
Total Claims
188
Beneficiaries
7
Codes Billed
2019-03
First Month
2022-08
Last Month

Provider Details

Authorized OfficialSTEWART, LAWRENCE (DDS/OWNER)
NPI Enumeration Date12/16/2018

Related Entities

Other providers sharing the same authorized official: STEWART, LAWRENCE

ProviderCityStateTotal Paid
SOUTHWEST MISSISSIPPI EAR, NOSE & THROAT CLINIC, P.A. MCCOMB MS $528K
FILL GOOD DENTAL CENTER PLLC DETROIT MI $480.00

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2019 83 $3K
2021 13 $524.00
2022 94 $2K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1110 Prophylaxis - adult 57 57 $2K
D0120 Periodic oral evaluation - established patient 56 56 $2K
D1120 Prophylaxis - child 14 14 $574.00
D0274 Bitewings - four radiographic images 13 13 $356.00
D0150 Comprehensive oral evaluation - new or established patient 12 12 $345.00
D0220 Intraoral - periapical first radiographic image 26 24 $320.00
D0230 Intraoral - periapical each additional radiographic image 12 12 $82.00