Dental
PGS D-Provider Dentistry PLLC
PGS D-Provider Dentistry PLLC was paid $41K by Medicaid between Jul 2020 and Dec 2024, across 10 billing codes. Its largest line is D1206, Topical application of fluoride varnish — 23% of everything it billed.
33Billing provider infoPGS D-PROVIDER DENTISTRY PLLC
MARYSVILLE, MI 48040
MARYSVILLE, MI 48040
33aNPI1639791585assigned 05/14/2020
33bProvider typeGeneral Practice Dentistry
28Total paid$41K
24GClaims1,370
24DCodes billed10
24AFirst – last monthJul 2020 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in Michigan
Rank by total paid#541 of 1,554
Median peer was paid$15K
This provider vs. median2.8×
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 | |
|---|---|---|---|
| 2020 | 126 | $4K | |
| 2021 | 329 | $10K | |
| 2022 | 472 | $14K | |
| 2024incomplete | 443 | $12K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1206 | Topical application of fluoride varnish | 23% | 413 | 412 | $9K |
| D1110 | Prophylaxis - adult | 22% | 195 | 195 | $9K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 22% | 372 | 372 | $9K |
| D1120 | Dental cleaning, childProphylaxis - child | 11% | 130 | 130 | $4K |
| D0150 | Comprehensive oral evaluation - new or established patient | 8.4% | 81 | 81 | $3K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 5.3% | 22 | 12 | $2K |
| D0330 | Panoramic radiographic image | 3.9% | 28 | 28 | $2K |
| D0274 | Bitewings - four radiographic images | 2.1% | 46 | 46 | $863.63 |
| D0220 | Intraoral - periapical first radiographic image | 1.8% | 55 | 55 | $716.92 |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 28 | 13 | $192.51 |
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 officialBARNES, SANDI (OFFICE MANAGER)
Parent organizationPGS D-PROVIDER DENTISTRY PLLC