Blue Diamond Family Dental SC

Blue Diamond Family Dental SC was paid $17K by Medicaid between Jan 2018 and Dec 2020, across 5 billing codes. Its largest line is D0120, dental checkup, returning patient — 51% of everything it billed.

33Billing provider infoBLUE DIAMOND FAMILY DENTAL SC
BLOOMER, WI 54724

33aNPI1245433580assigned 06/06/2007

33bProvider typeDentist

28Total paid$17K

24GClaims1,240

24DCodes billed5

24AFirst – last monthJan 2018 – Dec 2020

Compared with peers

Next to other Dentist providers in Wisconsin

Rank by total paid#110 of 185

Median peer was paid$28K

This provider vs. median0.6×

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	566	$7K
2019	311	$4K
2020	363	$5K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	51%	683	647	$9K
D1206	Topical application of fluoride varnish	20%	324	303	$3K
D1110	Prophylaxis - adult	19%	138	127	$3K
D1120	Dental cleaning, childProphylaxis - child	9.1%	79	74	$2K
D0272	Bitewings - two radiographic images	1.2%	16	16	$204.24

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 officialPARR, CONNIE (BUSINESS MANAGER)