Davidson, Shane

Davidson, Shane was paid $108K by Medicaid between Jan 2018 and Dec 2024, across 11 billing codes. Its largest line is D1110, Prophylaxis - adult — 52% of everything it billed.

33Billing provider infoDAVIDSON, SHANE
WEST BLOOMFIELD, MI 48324

33aNPI1710208053assigned 06/22/2010

33bProvider typeGeneral Practice Dentistry

28Total paid$108K

24GClaims3,484

24DCodes billed11

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other General Practice Dentistry providers in Michigan

Rank by total paid#351 of 1,554

Median peer was paid$15K

This provider vs. median7.4×

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
2018	1,075	$29K
2019	920	$24K
2020	81	$2K
2021	89	$3K
2022	284	$10K
2023	665	$25K
2024incomplete	370	$15K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1110	Prophylaxis - adult	52%	1,359	1,346	$57K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	30%	1,417	1,406	$33K
D0274	Bitewings - four radiographic images	3.4%	172	168	$4K
D1206	Topical application of fluoride varnish	2.8%	137	137	$3K
D1120	Dental cleaning, childProphylaxis - child	2.6%	73	73	$3K
D0330	Panoramic radiographic image	2.4%	92	88	$3K
D0150	Comprehensive oral evaluation - new or established patient	2.3%	93	91	$2K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	1.6%	27	25	$2K
D0220	Intraoral - periapical first radiographic image	1.0%	85	83	$1K
D2393	Resin-based composite - three surfaces, posterior, primary or permanent	<1%	14	12	$806.02
D0140	Limited oral evaluation - problem focused	<1%	15	15	$281.90

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.