NPI: 1699051888 · SAGINAW, MI 48602 · Dentist · NPI assigned 11/01/2011
| Authorized Official | HART, PATRICIA (CORPORATE MANAGER) |
| NPI Enumeration Date | 11/01/2011 |
Other providers sharing the same authorized official: HART, PATRICIA
| Provider | City | State | Total Paid |
|---|---|---|---|
| GREAT LAKES FAMILY DENTAL GROUP-MUNCIE, P.C. | MUNCIE | IN | $429K |
| C PATRICK GRAY DDS PC | FLINT | MI | $310K |
| GREAT LAKES FAMILY DENTAL GROUP BLISSFIELD PC | BLISSFIELD | MI | $142K |
| GREAT LAKES FAMILY DENTAL GROUP - TECUMSEH PC | TECUMSEH | MI | $102K |
| GREAT LAKES FAMILY DENTAL GROUP-ALMONT,P.C. | ALMONT | MI | $68K |
| GREAT LAKES FAMILY DENTAL GROUP-WARREN, P.C. | WARREN | MI | $30K |
| GREAT LAKES FAMILY DENTAL GROUP - MT MORRIS PC | MT MORRIS | MI | $15K |
| GREAT LAKES FAMILY DENTAL GROUP-ST. JOSEPH | SAINT JOSEPH | MI | $3K |
| GREAT LAKES FAMILY DENTALGROUP-HOWELL | HOWELL | MI | $3K |
| GREAT LAKES FAMILY DENTAL GROUP-DEWITT, P.C. | DEWITT | MI | $3K |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 1,639 | $57K |
| 2019 | 2,393 | $83K |
| 2020 | 2,344 | $83K |
| 2021 | 3,484 | $122K |
| 2022 | 2,960 | $91K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 2,159 | 2,153 | $81K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 678 | 451 | $79K |
| D0120 | Periodic oral evaluation - established patient | 2,537 | 2,529 | $65K |
| D1206 | Topical application of fluoride varnish | 2,561 | 2,553 | $58K |
| D1110 | Prophylaxis - adult | 914 | 910 | $43K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 370 | 279 | $32K |
| D0210 | Intraoral - complete series of radiographic images | 269 | 268 | $18K |
| D0274 | Bitewings - four radiographic images | 523 | 522 | $16K |
| D0220 | Intraoral - periapical first radiographic image | 1,041 | 1,032 | $16K |
| D0230 | Intraoral - periapical each additional radiographic image | 1,175 | 642 | $10K |
| D0272 | Bitewings - two radiographic images | 380 | 378 | $9K |
| D0150 | Comprehensive oral evaluation - new or established patient | 120 | 120 | $5K |
| D0140 | Limited oral evaluation - problem focused | 93 | 92 | $4K |