FAMILIA DENTAL MADISON EAST LLC
NPI: 1821451428
· MADISON, WI 53704
· General Practice Dentistry
· NPI assigned 03/31/2016
$5.88M
Total Medicaid Paid
Provider Details
| Authorized Official | TELLEZ, IVONNE (ENROLLMENT TEAM LEAD) |
| NPI Enumeration Date | 03/31/2016 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
41,116 |
$740K |
| 2019 |
32,345 |
$618K |
| 2020 |
36,538 |
$541K |
| 2021 |
39,089 |
$603K |
| 2022 |
45,521 |
$1.15M |
| 2023 |
38,651 |
$1.00M |
| 2024 |
47,406 |
$1.22M |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1351 |
|
26,470 |
2,580 |
$559K |
| D1110 |
|
18,147 |
16,842 |
$510K |
| D2392 |
|
8,153 |
5,376 |
$456K |
| D2391 |
|
9,629 |
5,493 |
$417K |
| D1206 |
|
30,173 |
27,872 |
$399K |
| D0150 |
|
18,644 |
17,030 |
$382K |
| D0274 |
|
20,752 |
19,300 |
$370K |
| D8670 |
|
2,764 |
2,379 |
$356K |
| D0220 |
|
36,953 |
33,643 |
$293K |
| D1120 |
|
12,435 |
11,386 |
$278K |
| D0120 |
|
16,559 |
15,542 |
$258K |
| D0140 |
|
10,560 |
9,630 |
$204K |
| D0230 |
|
35,417 |
27,907 |
$202K |
| D7140 |
|
5,112 |
2,176 |
$191K |
| D7210 |
|
1,958 |
1,184 |
$164K |
| D0330 |
|
5,628 |
5,035 |
$160K |
| D2393 |
|
1,866 |
1,382 |
$134K |
| D0272 |
|
7,808 |
7,190 |
$108K |
| D8660 |
|
776 |
616 |
$70K |
| D8080 |
|
88 |
65 |
$63K |
| D4355 |
|
622 |
604 |
$41K |
| D0470 |
|
630 |
507 |
$38K |
| D0340 |
|
852 |
673 |
$38K |
| D4346 |
|
439 |
416 |
$37K |
| D0210 |
|
791 |
753 |
$31K |
| D0350 |
|
771 |
606 |
$22K |
| D2335 |
|
233 |
152 |
$18K |
| D2332 |
|
251 |
169 |
$17K |
| D2330 |
|
397 |
165 |
$10K |
| D5110 |
|
32 |
25 |
$10K |
| D2331 |
|
278 |
147 |
$9K |
| D0270 |
|
1,277 |
1,078 |
$8K |
| D1208 |
|
368 |
340 |
$5K |
| D8680 |
|
16 |
15 |
$5K |
| D2394 |
|
64 |
57 |
$5K |
| D7250 |
|
68 |
12 |
$4K |
| D9110 |
|
145 |
119 |
$3K |
| D2940 |
|
26 |
21 |
$581.44 |
| D1999 |
|
3,514 |
2,946 |
$0.00 |