Dental
Calderon Mi Dental PLLC
Calderon Mi Dental PLLC was paid $38K by Medicaid between Feb 2022 and Dec 2024, across 4 billing codes. Its largest line is D0210, Intraoral - complete series of radiographic images — 35% of everything it billed.
33Billing provider infoCALDERON MI DENTAL PLLC
MONROE, MI 48162
MONROE, MI 48162
33aNPI1568940393assigned 08/03/2018
33bProvider typeGeneral Practice Dentistry
28Total paid$38K
24GClaims601
24DCodes billed4
24AFirst – last monthFeb 2022 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in Michigan
Rank by total paid#556 of 1,554
Median peer was paid$15K
This provider vs. median2.6×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2022 | 41 | $1K | |
| 2023 | 29 | $1K | |
| 2024incomplete | 531 | $36K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0210 | Intraoral - complete series of radiographic images | 35% | 198 | 198 | $13K |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 33% | 96 | 25 | $13K |
| D0150 | Comprehensive oral evaluation - new or established patient | 31% | 283 | 282 | $12K |
| D1206 | Topical application of fluoride varnish | <1% | 24 | 24 | $365.76 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialCALDERON, PETER (OWNER)