Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › MI › TECUMSEH › GREAT LAKES FAMILY DENTAL GROUP - TECUMSEH PC

GREAT LAKES FAMILY DENTAL GROUP - TECUMSEH PC

NPI: 1447342589 · TECUMSEH, MI 49286 · General Practice Dentistry · NPI assigned 09/28/2006

$102K
Total Medicaid Paid
3,392
Total Claims
3,383
Beneficiaries
7
Codes Billed
2018-04
First Month
2022-12
Last Month

Provider Details

Authorized OfficialHART, PATRICIA (GENERAL MANAGER)
NPI Enumeration Date09/28/2006

Related Entities

Other providers sharing the same authorized official: HART, PATRICIA

ProviderCityStateTotal Paid
GREAT LAKES FAMILY DENTAL GROUP SAGINAW, PC SAGINAW MI $436K
GREAT LAKES FAMILY DENTAL GROUP-MUNCIE, P.C. MUNCIE IN $429K
C PATRICK GRAY DDS PC FLINT MI $310K
GREAT LAKES FAMILY DENTAL GROUP BLISSFIELD PC BLISSFIELD MI $142K
GREAT LAKES FAMILY DENTAL GROUP-ALMONT,P.C. ALMONT MI $68K
GREAT LAKES FAMILY DENTAL GROUP-WARREN, P.C. WARREN MI $30K
GREAT LAKES FAMILY DENTAL GROUP - MT MORRIS PC MT MORRIS MI $15K
GREAT LAKES FAMILY DENTAL GROUP-ST. JOSEPH SAINT JOSEPH MI $3K
GREAT LAKES FAMILY DENTALGROUP-HOWELL HOWELL MI $3K
GREAT LAKES FAMILY DENTAL GROUP-DEWITT, P.C. DEWITT MI $3K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 496 $15K
2019 592 $18K
2020 677 $19K
2021 828 $23K
2022 799 $27K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1120 Prophylaxis - child 889 889 $34K
D0120 Periodic oral evaluation - established patient 1,241 1,241 $32K
D1206 Topical application of fluoride varnish 941 941 $22K
D1110 Prophylaxis - adult 247 246 $11K
D2391 Resin-based composite - one surface, posterior, primary or permanent 21 13 $2K
D0274 Bitewings - four radiographic images 28 28 $756.00
D0272 Bitewings - two radiographic images 25 25 $576.90