Setaputri, Andres

Setaputri, Andres was paid $11K by Medicaid between Jun 2018 and Aug 2021, across 4 billing codes. Its largest line is D1120, dental cleaning, child — 44% of everything it billed.

33Billing provider infoSETAPUTRI, ANDRES
SOUTHGATE, MI 48195

33aNPI1710393095assigned 07/07/2014

33bProvider typeGeneral Practice Dentistry

28Total paid$11K

24GClaims425

24DCodes billed4

24AFirst – last monthJun 2018 – Aug 2021

Compared with peers

Next to other General Practice Dentistry providers in Michigan

Rank by total paid#832 of 1,554

Median peer was paid$15K

This provider vs. median0.7×

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	24	$420.00
2019	74	$2K
2020	126	$3K
2021	201	$5K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1120	Dental cleaning, childProphylaxis - child	44%	143	143	$5K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	33%	164	164	$4K
D1206	Topical application of fluoride varnish	20%	106	106	$2K
D0150	Comprehensive oral evaluation - new or established patient	3.4%	12	12	$360.00

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.