COUNTY OF LA CROSSE
NPI: 1538165766
· LA CROSSE, WI 54601
· Case Management Agency
· NPI assigned 06/22/2005
$338K
Total Medicaid Paid
Provider Details
| Authorized Official | MARTINE, AUDRA (DIRECTOR) |
| NPI Enumeration Date | 06/22/2005 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
4,301 |
$50K |
| 2019 |
4,744 |
$47K |
| 2020 |
669 |
$7K |
| 2021 |
1,624 |
$23K |
| 2022 |
2,908 |
$57K |
| 2023 |
3,803 |
$77K |
| 2024 |
4,076 |
$76K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1351 |
Sealant - per tooth |
6,229 |
1,872 |
$125K |
| D1206 |
Topical application of fluoride varnish |
6,805 |
6,699 |
$99K |
| D0191 |
|
4,137 |
4,087 |
$53K |
| D1120 |
Prophylaxis - child |
697 |
695 |
$21K |
| T1016 |
Case management, each 15 minutes |
776 |
629 |
$12K |
| 83655 |
|
1,049 |
725 |
$7K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,126 |
783 |
$6K |
| D1110 |
Prophylaxis - adult |
165 |
164 |
$6K |
| H1000 |
Prenatal care, at-risk assessment |
103 |
99 |
$4K |
| H1002 |
Prenatal care, at risk enhanced service; care coordination |
62 |
62 |
$3K |
| 36416 |
|
923 |
653 |
$1K |
| 90688 |
|
25 |
25 |
$285.00 |
| 90686 |
|
28 |
28 |
$231.41 |