Midwest Periodontal and Oral Reconstruction, P.C.

Midwest Periodontal and Oral Reconstruction, P.C. was paid $35K by Medicaid between Jan 2018 and Aug 2023, across 8 billing codes. Its largest line is D1110, Prophylaxis - adult — 45% of everything it billed.

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
2018	151	$302.71
2019	192	$5K
2020	311	$10K
2021	302	$10K
2022	154	$5K
2023	163	$5K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1110	Prophylaxis - adult	45%	381	330	$16K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	26%	531	457	$9K
D0150	Comprehensive oral evaluation - new or established patient	10%	114	95	$4K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	8.1%	43	24	$3K
D1208	Topical application of fluoride, excluding varnish	4.5%	129	113	$2K
D1120	Dental cleaning, childProphylaxis - child	3.1%	41	35	$1K
D0210	Intraoral - complete series of radiographic images	2.4%	12	12	$825.60
D0274	Bitewings - four radiographic images	1.4%	22	15	$488.16

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 officialMILLS, BRIGITTE (DIRECTOR OF BUSINESS AFFAIRS)