Clinic
Wisconsin Smiles
Wisconsin Smiles was paid $563K by Medicaid between Jan 2021 and Dec 2024, across 17 billing codes. Its largest line is D0330, Panoramic radiographic image — 23% of everything it billed.
33Billing provider infoWISCONSIN SMILES
MILWAUKEE, WI 53216
MILWAUKEE, WI 53216
33aNPI1467059865assigned 10/08/2020
33bProvider typeDental Clinic/Center
28Total paid$563K
24GClaims14,169
24DCodes billed17
24AFirst – last monthJan 2021 – Dec 2024
Compared with peers
Next to other Dental Clinic/Center providers in Wisconsin
Rank by total paid#30 of 51
Median peer was paid$1.07M
This provider vs. median0.5×
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 | 4,179 | $179K | |
| 2022 | 4,010 | $163K | |
| 2023 | 3,301 | $129K | |
| 2024incomplete | 2,679 | $92K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0330 | Panoramic radiographic image | 23% | 2,200 | 2,098 | $131K |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 13% | 448 | 233 | $71K |
| D0150 | Comprehensive oral evaluation - new or established patient | 8.2% | 1,830 | 1,729 | $46K |
| D1208 | Topical application of fluoride, excluding varnish | 7.2% | 2,553 | 2,409 | $41K |
| D1110 | Prophylaxis - adult | 7.0% | 1,202 | 1,129 | $39K |
| D9110 | 6.0% | 639 | 607 | $34K | |
| D0140 | Limited oral evaluation - problem focused | 5.9% | 992 | 933 | $33K |
| D0210 | Intraoral - complete series of radiographic images | 4.7% | 519 | 477 | $27K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 4.5% | 439 | 155 | $25K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 3.7% | 272 | 128 | $21K |
| D4346 | 3.7% | 217 | 208 | $21K | |
| D0274 | Bitewings - four radiographic images | 3.6% | 849 | 799 | $20K |
5 more codes
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 (PRESIDENT)
Parent organizationWISCONSIN SMILES
| Provider | Location | Paid |
|---|---|---|
| Wisconsin Smiles | Racine, WI | $1.39M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.