Dental
Derose, Nicolet
Derose, Nicolet was paid $1.67M by Medicaid between Jan 2018 and Dec 2024, across 19 billing codes. Its largest line is D1120, dental cleaning, child — 17% of everything it billed.
33Billing provider infoDEROSE, NICOLET
RACINE, WI 53403
RACINE, WI 53403
33aNPI1194892166assigned 11/29/2006
33bProvider typePediatric Dentist
28Total paid$1.67M
24GClaims46,073
24DCodes billed19
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Wisconsin
Rank by total paid#10 of 61
Median peer was paid$85K
This provider vs. median20×
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 | 7,412 | $253K | |
| 2019 | 6,876 | $237K | |
| 2020 | 5,610 | $185K | |
| 2021 | 6,882 | $210K | |
| 2022 | 6,631 | $260K | |
| 2023 | 6,830 | $277K | |
| 2024incomplete | 5,832 | $252K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 17% | 8,452 | 8,114 | $276K |
| D1206 | Topical application of fluoride varnish | 14% | 12,212 | 11,728 | $237K |
| D8670 | Periodic orthodontic treatment visit | 11% | 2,249 | 2,000 | $184K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 9.6% | 6,728 | 6,463 | $161K |
| D1110 | Prophylaxis - adult | 9.2% | 3,754 | 3,633 | $154K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 8.9% | 1,215 | 854 | $149K |
| D0330 | Panoramic radiographic image | 8.2% | 2,280 | 2,165 | $137K |
| D0150 | Comprehensive oral evaluation - new or established patient | 6.3% | 3,031 | 2,907 | $105K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 6.1% | 1,296 | 736 | $102K |
| D1351 | Sealant - per tooth | 3.4% | 2,518 | 850 | $57K |
| D7140 | Extraction, erupted tooth or exposed root | 1.6% | 417 | 281 | $26K |
| D9248 | 1.5% | 168 | 155 | $25K |
7 more codes
| D0272 | Bitewings - two radiographic images | <1% | 724 | $15K |
| D0140 | Limited oral evaluation - problem focused | <1% | 478 | $15K |
| D2140 | <1% | 216 | $13K | |
| D9110 | <1% | 175 | $9K | |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 89 | $6K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | <1% | 44 | $3K |
| D0220 | Intraoral - periapical first radiographic image | <1% | 27 | $340.60 |
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.