Dental
Fowler Memorial Free Dental Clinic
Fowler Memorial Free Dental Clinic was paid $326K by Medicaid between Feb 2018 and Dec 2024, across 23 billing codes. Its largest line is D1120, dental cleaning, child — 14% of everything it billed.
33Billing provider infoFOWLER MEMORIAL FREE DENTAL CLINIC
MONROE, WI 53566
MONROE, WI 53566
33aNPI1073754024assigned 03/19/2009
33bProvider typeGeneral Practice Dentistry
28Total paid$326K
24GClaims16,698
24DCodes billed23
24AFirst – last monthFeb 2018 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in Wisconsin
Rank by total paid#46 of 208
Median peer was paid$26K
This provider vs. median13×
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 | 519 | $5K | |
| 2019 | 917 | $11K | |
| 2020 | 1,030 | $17K | |
| 2021 | 3,683 | $69K | |
| 2022 | 3,730 | $74K | |
| 2023 | 3,581 | $55K | |
| 2024incomplete | 3,238 | $95K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 14% | 2,041 | 1,796 | $45K |
| D1206 | Topical application of fluoride varnish | 13% | 3,266 | 2,855 | $44K |
| D0210 | Intraoral - complete series of radiographic images | 10% | 793 | 754 | $33K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 9.6% | 1,926 | 1,612 | $31K |
| D1110 | Prophylaxis - adult | 7.7% | 855 | 786 | $25K |
| D0150 | Comprehensive oral evaluation - new or established patient | 7.7% | 1,234 | 1,087 | $25K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 5.9% | 271 | 177 | $19K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 5.2% | 291 | 184 | $17K |
| D0140 | Limited oral evaluation - problem focused | 4.6% | 696 | 612 | $15K |
| D0274 | Bitewings - four radiographic images | 3.5% | 529 | 478 | $12K |
| D1351 | Sealant - per tooth | 3.0% | 574 | 91 | $10K |
| D2940 | 3.0% | 281 | 173 | $10K |
11 more codes
| D0330 | Panoramic radiographic image | 2.9% | 309 | $10K |
| D1354 | 2.8% | 1,110 | $9K | |
| D0220 | Intraoral - periapical first radiographic image | 1.7% | 651 | $6K |
| D4346 | 1.6% | 65 | $5K | |
| D0272 | Bitewings - two radiographic images | 1.0% | 200 | $3K |
| D2150 | Silver amalgam - two surfaces, primary or permanent | <1% | 63 | $3K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 17 | $2K |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 224 | $1K |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 29 | $880.76 |
| D0270 | <1% | 42 | $433.74 | |
| D1330 | 0% | 1,231 | $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 officialBLIVEN, ANNAMARIA (CLINIC COORDINATOR)