Dental
Misa04, LLC
Misa04, LLC was paid $768K by Medicaid between May 2023 and Nov 2024, across 24 billing codes. Its largest line is D2740, Crown - porcelain/ceramic — 37% of everything it billed.
33Billing provider infoMISA04, LLC
MISSOULA, MT 59801
MISSOULA, MT 59801
33aNPI1588366611assigned 03/21/2023
33bProvider typeGeneral Practice Dentistry
28Total paid$768K
24GClaims9,052
24DCodes billed24
24AFirst – last monthMay 2023 – Nov 2024
Compared with peers
Next to other General Practice Dentistry providers in Montana
Rank by total paid#15 of 149
Median peer was paid$40K
This provider vs. median19×
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 | |
|---|---|---|---|
| 2023 | 4,594 | $381K | |
| 2024incomplete | 4,458 | $387K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2740 | Crown - porcelain/ceramic | 37% | 486 | 370 | $284K |
| D0367 | 11% | 335 | 299 | $87K | |
| D2950 | 7.4% | 467 | 354 | $57K | |
| D9243 | 6.2% | 174 | 132 | $48K | |
| D1110 | Prophylaxis - adult | 5.4% | 845 | 773 | $41K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 3.8% | 242 | 131 | $30K |
| D4910 | 3.8% | 453 | 411 | $29K | |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | 3.3% | 248 | 66 | $26K |
| D0274 | Bitewings - four radiographic images | 2.8% | 666 | 594 | $21K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 2.8% | 915 | 850 | $21K |
| D0140 | Limited oral evaluation - problem focused | 2.7% | 613 | 559 | $20K |
| D1206 | Topical application of fluoride varnish | 2.2% | 854 | 782 | $17K |
12 more codes
| D0220 | Intraoral - periapical first radiographic image | 1.7% | 802 | $13K |
| D9612 | 1.5% | 136 | $12K | |
| D9239 | 1.5% | 133 | $11K | |
| D4341 | 1.4% | 61 | $11K | |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.3% | 316 | $10K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 1.1% | 57 | $8K |
| D0270 | <1% | 445 | $7K | |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 78 | $4K |
| D0210 | Intraoral - complete series of radiographic images | <1% | 49 | $4K |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 497 | $4K |
| D0330 | Panoramic radiographic image | <1% | 27 | $908.32 |
| D0350 | <1% | 153 | $704.04 |
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 officialWINTERHOLLER, WILLIAM (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Morrison Family Dentistry PC | Laurel, MT | $237K |
| WCW Dental LLC | Billings, MT | $65K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.