Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
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LAC DU FLAMBEAU BAND OF LAKE SUPERIOR CHIPPEWA INDIANS

NPI: 1427347426 · LAC DU FLAMBEAU, WI 54538 · Federally Qualified Health Center (FQHC) · NPI assigned 03/31/2011

$2.18M
Total Medicaid Paid
65,252
Total Claims
57,315
Beneficiaries
34
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialWOLFE, JEANNE (COMPLIANCE OFFICER)
Parent OrganizationLAC DU FLAMBEAU BAND OF LAKE SUPERIOR CHIPPEWA INDIANS
NPI Enumeration Date03/31/2011

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 6,800 $200K
2019 7,693 $252K
2020 5,846 $182K
2021 8,147 $254K
2022 12,264 $454K
2023 13,086 $460K
2024 11,416 $372K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D8670 Periodic orthodontic treatment visit 8,719 8,455 $872K
D0140 Limited oral evaluation - problem focused 7,841 7,562 $166K
D1206 Topical application of fluoride varnish 9,718 9,462 $133K
D1110 Prophylaxis - adult 4,352 4,297 $130K
D7140 Extraction, erupted tooth or exposed root 2,081 702 $112K
D0330 Panoramic radiographic image 3,005 2,855 $95K
D1351 Sealant - per tooth 4,658 878 $74K
D0150 Comprehensive oral evaluation - new or established patient 3,262 3,174 $72K
D0220 Intraoral - periapical first radiographic image 7,384 7,056 $64K
D0160 1,217 1,166 $58K
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 920 686 $52K
D8080 Comprehensive orthodontic treatment of the adolescent dentition 83 72 $52K
D0120 Periodic oral evaluation - established patient 3,105 3,052 $49K
D1120 Prophylaxis - child 1,849 1,824 $45K
D0210 Intraoral - complete series of radiographic images 953 928 $42K
D0274 Bitewings - four radiographic images 2,114 2,077 $41K
D9243 349 302 $33K
D9239 291 275 $15K
D2391 Resin-based composite - one surface, posterior, primary or permanent 314 216 $14K
D0230 Intraoral - periapical each additional radiographic image 814 707 $12K
D0240 585 299 $8K
D3330 Endodontic therapy, molar tooth (excluding final restoration) 35 31 $7K
D0272 Bitewings - two radiographic images 376 371 $4K
D1354 435 120 $4K
D0191 289 278 $3K
D0350 126 121 $3K
D0340 84 82 $2K
D2940 78 68 $2K
D2393 Resin-based composite - three surfaces, posterior, primary or permanent 42 37 $2K
D9230 Inhalation of nitrous oxide / analgesia, anxiolysis 57 51 $2K
D0170 60 59 $1K
D8660 13 13 $870.02
D0470 28 26 $769.68
D0270 15 13 $91.04