Dental
Willow Pediatric Dentistry of Tecumseh
Willow Pediatric Dentistry of Tecumseh was paid $2.43M by Medicaid between Jul 2020 and Dec 2024, across 23 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 30% of everything it billed.
33Billing provider infoWILLOW PEDIATRIC DENTISTRY OF TECUMSEH
TECUMSEH, MI 49286
TECUMSEH, MI 49286
33aNPI1700494275assigned 07/21/2020
33bProvider typePediatric Dentist
28Total paid$2.43M
24GClaims48,877
24DCodes billed23
24AFirst – last monthJul 2020 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Michigan
Rank by total paid#31 of 153
Median peer was paid$464K
This provider vs. median5.2×
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 | 4,322 | $207K | |
| 2021 | 10,453 | $522K | |
| 2022 | 12,489 | $647K | |
| 2023 | 11,432 | $566K | |
| 2024incomplete | 10,181 | $489K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 30% | 3,891 | 1,811 | $718K |
| D1120 | Dental cleaning, childProphylaxis - child | 12% | 7,312 | 7,309 | $291K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 9.5% | 1,974 | 1,241 | $232K |
| D1206 | Topical application of fluoride varnish | 8.1% | 7,411 | 7,410 | $198K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 8.0% | 6,159 | 6,157 | $194K |
| D7140 | Extraction, erupted tooth or exposed root | 7.6% | 2,186 | 1,151 | $186K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 5.8% | 1,577 | 1,110 | $141K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 4.2% | 830 | 558 | $103K |
| D0272 | Bitewings - two radiographic images | 3.5% | 3,588 | 3,585 | $86K |
| D0220 | Intraoral - periapical first radiographic image | 2.9% | 3,957 | 3,887 | $70K |
| D0140 | Limited oral evaluation - problem focused | 2.5% | 1,030 | 1,015 | $60K |
| D0230 | Intraoral - periapical each additional radiographic image | 1.8% | 3,340 | 2,354 | $43K |
11 more codes
| D0150 | Comprehensive oral evaluation - new or established patient | 1.7% | 718 | $42K |
| D1351 | Sealant - per tooth | <1% | 623 | $18K |
| D1354 | <1% | 699 | $17K | |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 320 | $13K |
| D0330 | Panoramic radiographic image | <1% | 82 | $6K |
| D9310 | <1% | 75 | $5K | |
| D1510 | <1% | 16 | $3K | |
| D0274 | Bitewings - four radiographic images | <1% | 67 | $3K |
| D2332 | <1% | 17 | $2K | |
| D1110 | Prophylaxis - adult | <1% | 37 | $2K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 0% | 2,968 | $0.00 |
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 officialATZMON, JODY (OWNER/PROVIDER)