BDD OF MICHIGAN P.C.

NPI: 1538830591 · LANSING, MI 48910 · General Practice Dentistry · NPI assigned 09/21/2021

$374K

Total Medicaid Paid

6,280

Total Claims

5,958

Beneficiaries

Codes Billed

2023-02

First Month

2024-12

Last Month

Provider Details

Authorized Official	MOORE, STEPHANIE (DIRECTOR OF REVENUE CYCLE)
Parent Organization	BDD OF MICHIGAN PC
NPI Enumeration Date	09/21/2021

Other providers sharing the same authorized official: MOORE, STEPHANIE

Provider	City	State	Total Paid
ARCHWAY STATION INC	CUMBERLAND	MD	$18.53M
ARCHWAY STATION, INC.	OAKLAND	MD	$3.98M
ARCHWAY STATION, INC.	CUMBERLAND	MD	$1.07M
BY STEPHANIE A	SICKLERVILLE	NJ	$84K
MULTI-CULTURAL LEARNING CENTER AND THERAPEUTIC SERVICES INC.	MAPLE SHADE	NJ	$15K
ADVANCED HEARING CARE PC	BARTLESVILLE	OK	$1K

Year	Claims	Total Paid
2023	2,834	$166K
2024	3,446	$208K

Code	Description	Claims	Beneficiaries	Total Paid
D2740	Crown - porcelain/ceramic	209	155	$131K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	447	298	$53K
D1110	Prophylaxis - adult	846	845	$43K
D0120	Periodic oral evaluation - established patient	892	891	$24K
D0150	Comprehensive oral evaluation - new or established patient	478	478	$20K
D2391	Resin-based composite - one surface, posterior, primary or permanent	170	120	$16K
D1120	Prophylaxis - child	407	407	$15K
D0274	Bitewings - four radiographic images	465	465	$14K
D0220	Intraoral - periapical first radiographic image	823	802	$14K
D0140	Limited oral evaluation - problem focused	292	289	$13K
D1206	Topical application of fluoride varnish	567	566	$13K
D0210	Intraoral - complete series of radiographic images	119	119	$8K
D0230	Intraoral - periapical each additional radiographic image	530	496	$5K
D2393	Resin-based composite - three surfaces, posterior, primary or permanent	23	15	$3K
D2330		12	12	$1K