Family Dentistry of Caledonia

Family Dentistry of Caledonia was paid $40K by Medicaid between Jan 2018 and Jan 2020, across 5 billing codes. Its largest line is D0120, dental checkup, returning patient — 35% of everything it billed.

33Billing provider infoFAMILY DENTISTRY OF CALEDONIA
CALEDONIA, MI 49316

33aNPI1942333497assigned 03/13/2007

33bProvider typeGeneral Practice Dentistry

28Total paid$40K

24GClaims1,284

24DCodes billed5

24AFirst – last monthJan 2018 – Jan 2020

Compared with peers

Next to other General Practice Dentistry providers in Michigan

Rank by total paid#544 of 1,554

Median peer was paid$15K

This provider vs. median2.8×

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	684	$22K
2019	536	$17K
2020	64	$2K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	35%	498	497	$14K
D1120	Dental cleaning, childProphylaxis - child	32%	326	326	$13K
D1206	Topical application of fluoride varnish	22%	355	355	$9K
D1110	Prophylaxis - adult	6.5%	50	50	$3K
D0274	Bitewings - four radiographic images	4.8%	55	55	$2K

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 officialSCOTT, GARY (PRESIDENT)