Clinic
Wisconsin Smiles
Wisconsin Smiles was paid $1.39M by Medicaid between Nov 2019 and Dec 2024, across 25 billing codes. Its largest line is D7210, Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth — 17% of everything it billed.
33Billing provider infoWISCONSIN SMILES
RACINE, WI 53406
RACINE, WI 53406
33aNPI1457905861assigned 07/25/2019
33bProvider typeDental Clinic/Center
28Total paid$1.39M
24GClaims36,499
24DCodes billed25
24AFirst – last monthNov 2019 – Dec 2024
Compared with peers
Next to other Dental Clinic/Center providers in Wisconsin
Rank by total paid#18 of 51
Median peer was paid$1.07M
This provider vs. median1.3×
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 | |
|---|---|---|---|
| 2019 | 630 | $21K | |
| 2020 | 5,145 | $156K | |
| 2021 | 9,362 | $322K | |
| 2022 | 7,093 | $299K | |
| 2023 | 6,913 | $258K | |
| 2024incomplete | 7,356 | $329K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 17% | 2,075 | 924 | $233K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 11% | 2,140 | 1,133 | $153K |
| D0210 | Intraoral - complete series of radiographic images | 9.4% | 2,774 | 2,580 | $130K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 7.0% | 1,184 | 685 | $97K |
| D1110 | Prophylaxis - adult | 6.4% | 2,628 | 2,463 | $89K |
| D0150 | Comprehensive oral evaluation - new or established patient | 6.2% | 3,472 | 3,242 | $85K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 5.5% | 1,440 | 685 | $77K |
| D0330 | Panoramic radiographic image | 4.8% | 1,838 | 1,669 | $67K |
| D1208 | Topical application of fluoride, excluding varnish | 4.8% | 4,299 | 3,965 | $66K |
| D0140 | Limited oral evaluation - problem focused | 4.7% | 2,196 | 2,018 | $66K |
| D1351 | Sealant - per tooth | 4.7% | 2,663 | 334 | $65K |
| D0274 | Bitewings - four radiographic images | 4.1% | 2,353 | 2,178 | $57K |
13 more codes
| D0120 | Dental checkup, returning patient | 3.8% | 2,590 | $52K |
| D4355 | 3.6% | 948 | $50K | |
| D1120 | Dental cleaning, child | 2.7% | 1,194 | $38K |
| D0220 | Intraoral - periapical first radiographic image | 1.4% | 1,580 | $20K |
| D9110 | <1% | 309 | $11K | |
| D2335 | <1% | 87 | $7K | |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 73 | $7K |
| D2394 | <1% | 50 | $5K | |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 466 | $4K |
| D2954 | <1% | 30 | $3K | |
| D4346 | <1% | 28 | $2K | |
| D2332 | <1% | 28 | $2K | |
| D0170 | <1% | 54 | $985.22 |
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 officialKHAN, HIDAYATHULLA (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Wisconsin Smiles | Milwaukee, WI | $563K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.