MICHIGAN DENTAL TEAM, PLLC
NPI: 1578335014
· MADISON HEIGHTS, MI 48071
· Dentist
· NPI assigned 10/27/2023
$639K
Total Medicaid Paid
Provider Details
| Authorized Official | ZORA, DIAA (OWNER) |
| NPI Enumeration Date | 10/27/2023 |
Related Entities
Other providers sharing the same authorized official: ZORA, DIAA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
6,357 |
$639K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D2930 |
Prefabricated stainless steel crown - primary tooth |
1,583 |
267 |
$338K |
| D7140 |
Extraction, erupted tooth or exposed root |
846 |
237 |
$93K |
| D9420 |
|
265 |
265 |
$81K |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
347 |
151 |
$48K |
| D0140 |
Limited oral evaluation - problem focused |
498 |
498 |
$32K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,379 |
245 |
$14K |
| D2934 |
|
43 |
17 |
$11K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
211 |
210 |
$7K |
| D0210 |
Intraoral - complete series of radiographic images |
107 |
102 |
$5K |
| D0272 |
Bitewings - two radiographic images |
189 |
187 |
$4K |
| D1351 |
Sealant - per tooth |
98 |
27 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
149 |
141 |
$3K |
| D0350 |
|
259 |
170 |
$0.00 |
| D0603 |
|
383 |
374 |
$0.00 |