Fletcher-Stark, Madelyn

Fletcher-Stark, Madelyn was paid $6K by Medicaid between Sep 2021 and Dec 2022, across 8 billing codes. Its largest line is D1208, Topical application of fluoride, excluding varnish — 24% of everything it billed.

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	12	$129.13
2022	290	$6K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1208	Topical application of fluoride, excluding varnish	24%	80	80	$1K
D1120	Dental cleaning, childProphylaxis - child	20%	37	37	$1K
D0150	Comprehensive oral evaluation - new or established patient	16%	27	27	$940.09
D0220	Intraoral - periapical first radiographic image	11%	58	58	$655.98
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	9.9%	26	26	$580.45
D0230	Intraoral - periapical each additional radiographic image	8.3%	49	40	$486.59
D0274	Bitewings - four radiographic images	6.1%	12	12	$356.77
D1206	Topical application of fluoride varnish	4.0%	13	13	$235.18

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.