Dental
LA Petite Dentistry
LA Petite Dentistry was paid $85K by Medicaid between Jan 2018 and Apr 2018, across 18 billing codes. Its largest line is D1351, Sealant - per tooth — 15% of everything it billed.
33Billing provider infoLA PETITE DENTISTRY
HUDSON, WI 54016
HUDSON, WI 54016
33aNPI1467747303assigned 06/17/2011
33bProvider typePediatric Dentist
28Total paid$85K
24GClaims5,641
24DCodes billed18
24AFirst – last monthJan 2018 – Apr 2018
Compared with peers
Next to other Pediatric Dentist providers in Wisconsin
Rank by total paid#31 of 61
Median peer was paid$85K
This provider vs. median1.0×
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 | 5,641 | $85K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1351 | Sealant - per tooth | 15% | 823 | 174 | $13K |
| D1120 | Dental cleaning, childProphylaxis - child | 12% | 513 | 496 | $10K |
| D0240 | 12% | 1,005 | 486 | $10K | |
| D1206 | Topical application of fluoride varnish | 8.9% | 636 | 612 | $8K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 8.7% | 508 | 491 | $7K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 7.9% | 179 | 162 | $7K |
| D0230 | Intraoral - periapical each additional radiographic image | 5.1% | 787 | 256 | $4K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 4.4% | 51 | 31 | $4K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 4.3% | 70 | 50 | $4K |
| D0274 | Bitewings - four radiographic images | 4.0% | 212 | 203 | $3K |
| D1110 | Prophylaxis - adult | 3.9% | 132 | 124 | $3K |
| D0210 | Intraoral - complete series of radiographic images | 3.6% | 79 | 76 | $3K |
6 more codes
| D0150 | Comprehensive oral evaluation - new or established patient | 3.0% | 127 | $3K |
| D7140 | Extraction, erupted tooth or exposed root | 2.7% | 60 | $2K |
| D0220 | Intraoral - periapical first radiographic image | 2.5% | 290 | $2K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 21 | $743.79 |
| D0140 | Limited oral evaluation - problem focused | <1% | 27 | $418.25 |
| D1330 | 0% | 121 | $0.00 |
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 officialMANCINI, ANDY (OWNER/PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| Purple Tooth Dental | Mt Holly, NC | $11K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.