Clinic
LTC Dental
LTC Dental was paid $1.18M by Medicaid between Feb 2021 and Dec 2024, across 12 billing codes. Its largest line is D1110, Prophylaxis - adult — 23% of everything it billed.
33Billing provider infoLTC DENTAL
SAINT FRANCIS, WI 53235
SAINT FRANCIS, WI 53235
33aNPI1124619556assigned 01/28/2021
33bProvider typeDental Clinic/Center
28Total paid$1.18M
24GClaims38,844
24DCodes billed12
24AFirst – last monthFeb 2021 – Dec 2024
Compared with peers
Next to other Dental Clinic/Center providers in Wisconsin
Rank by total paid#24 of 51
Median peer was paid$1.07M
This provider vs. median1.1×
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 | |
|---|---|---|---|
| 2021 | 5,113 | $180K | |
| 2022 | 12,985 | $490K | |
| 2023 | 11,171 | $268K | |
| 2024incomplete | 9,575 | $237K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 23% | 8,034 | 7,731 | $274K |
| D9410 | 23% | 6,279 | 6,116 | $269K | |
| D5110 | 15% | 404 | 375 | $181K | |
| D0191 | 15% | 13,869 | 13,311 | $175K | |
| D1206 | Topical application of fluoride varnish | 11% | 8,436 | 8,116 | $131K |
| D5120 | 7.7% | 212 | 196 | $91K | |
| D4355 | 1.8% | 302 | 298 | $21K | |
| D0140 | Limited oral evaluation - problem focused | 1.6% | 914 | 865 | $19K |
| D0210 | Intraoral - complete series of radiographic images | 1.0% | 205 | 202 | $12K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | <1% | 106 | 105 | $2K |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 41 | 39 | $516.57 |
| D0220 | Intraoral - periapical first radiographic image | <1% | 42 | 41 | $403.94 |
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 officialROBINSON, TARA (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Maumee Bay Family Practice, INC. | Oregon, OH | $163K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.