St.Germain, Ada

St.Germain, Ada was paid $2K by Medicaid between Jul 2018 and Aug 2018, across 2 billing codes. Its largest line is D1206, Topical application of fluoride varnish — 50% 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
2018	56	$2K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1206	Topical application of fluoride varnish	50%	30	30	$1K
D1120	Dental cleaning, childProphylaxis - child	50%	26	26	$1K

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.