MICHELLE D. BROWN DDS, & MICHAEL B. MOORE DDS, INC.

$2.42M

Total Medicaid Paid

65,511

Total Claims

46,354

Beneficiaries

22

Codes Billed

2018-01

First Month

2023-12

Last Month

Authorized Official	BROWN, MICHELLE (PRESIDENT)
NPI Enumeration Date	09/21/2006

Provider	City	State	Total Paid
FRIENDS & FAMILY ADULT DAY SERVICES, INC.	WINDSOR MILL	MD	$4.50M
PROVIDENTIAL BBA OPERATING LP	BOUNTIFUL	UT	$1.73M
SUNDANCE DENTAL CARE OF RIO RANCHO, LLC	RIO RANCHO	NM	$971K
STATE OF MISSISSIPPI- UNIVERSITY OF MISSISSIPPI MEDICAL CENTER	JACKSON	MS	$203.52

Code	Description	Claims	Beneficiaries	Total Paid
D7140	Extraction, erupted tooth or exposed root	5,364	2,035	$358K
D1351	Sealant - per tooth	9,111	1,706	$261K
D0330	Panoramic radiographic image	3,614	3,054	$221K
D1120	Prophylaxis - child	5,561	4,794	$206K
D1110	Prophylaxis - adult	4,005	3,505	$204K
D0150	Comprehensive oral evaluation - new or established patient	5,653	4,906	$188K
D1208	Topical application of fluoride, excluding varnish	8,702	7,455	$173K
D0274	Bitewings - four radiographic images	4,439	3,832	$155K
D0140	Limited oral evaluation - problem focused	4,170	3,471	$139K
D2140		1,636	987	$95K
D0120	Periodic oral evaluation - established patient	3,274	2,840	$78K
D2391	Resin-based composite - one surface, posterior, primary or permanent	817	525	$76K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	551	417	$65K
D0272	Bitewings - two radiographic images	2,630	2,263	$63K
D2150	Silver amalgam - two surfaces, primary or permanent	788	533	$57K
D0220	Intraoral - periapical first radiographic image	3,298	2,735	$50K
D1206	Topical application of fluoride varnish	624	617	$13K
D0230	Intraoral - periapical each additional radiographic image	697	262	$6K
D2335		36	28	$5K
D0145	Oral evaluation for a patient under three years of age	141	131	$3K
D9995		45	26	$346.50
D1999		355	232	$0.00

Medicaid Provider Spending