Clinic
Extra Dental PC
Extra Dental PC was paid $3K by Medicaid between Aug 2023 and Sep 2024, across 4 billing codes. Its largest line is D1110, Prophylaxis - adult — 41% of everything it billed.
33Billing provider infoEXTRA DENTAL PC
SHELBY TOWNSHIP, MI 48316
SHELBY TOWNSHIP, MI 48316
33aNPI1598400293assigned 04/28/2022
33bProvider typeDental Clinic/Center
28Total paid$3K
24GClaims83
24DCodes billed4
24AFirst – last monthAug 2023 – Sep 2024
Compared with peers
Next to other Dental Clinic/Center providers in Michigan
Rank by total paid#321 of 431
Median peer was paid$24K
This provider vs. median0.1×
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 | |
|---|---|---|---|
| 2023 | 15 | $616.55 | |
| 2024incomplete | 68 | $3K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 41% | 25 | 25 | $1K |
| D0150 | Comprehensive oral evaluation - new or established patient | 40% | 31 | 30 | $1K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 12% | 14 | 14 | $417.82 |
| D0220 | Intraoral - periapical first radiographic image | 6.9% | 13 | 13 | $231.58 |
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 officialYASEEN, LINA (DENTIST/OWNER)