Clinic
LA Crosse Pediatric Dentistry LLC
LA Crosse Pediatric Dentistry LLC was paid $1.02M by Medicaid between Jan 2018 and Dec 2019, across 24 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 36% of everything it billed.
33Billing provider infoLA CROSSE PEDIATRIC DENTISTRY LLC
LA CROSSE, WI 54603
LA CROSSE, WI 54603
33aNPI1831550813assigned 03/17/2016
33bProvider typeClinic/Center
28Total paid$1.02M
24GClaims28,690
24DCodes billed24
24AFirst – last monthJan 2018 – Dec 2019
Compared with peers
Next to other Clinic/Center providers in Wisconsin
Rank by total paid#14 of 102
Median peer was paid$54K
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 | |
|---|---|---|---|
| 2018 | 14,658 | $521K | |
| 2019 | 14,032 | $501K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 36% | 2,480 | 669 | $365K |
| D1120 | Dental cleaning, childProphylaxis - child | 9.7% | 4,632 | 4,507 | $99K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 7.5% | 1,151 | 602 | $77K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 6.5% | 4,274 | 4,167 | $66K |
| D1206 | Topical application of fluoride varnish | 5.7% | 4,699 | 4,575 | $58K |
| D9420 | 5.4% | 269 | 262 | $55K | |
| D1351 | Sealant - per tooth | 4.5% | 2,379 | 831 | $46K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 4.5% | 1,210 | 1,153 | $46K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 3.7% | 732 | 466 | $38K |
| D9248 | 3.7% | 392 | 368 | $38K | |
| D7140 | Extraction, erupted tooth or exposed root | 3.3% | 660 | 373 | $34K |
| D0272 | Bitewings - two radiographic images | 3.0% | 2,285 | 2,218 | $30K |
12 more codes
| D0140 | Limited oral evaluation - problem focused | 1.7% | 878 | $18K |
| D0210 | Intraoral - complete series of radiographic images | 1.5% | 360 | $16K |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.1% | 594 | $12K |
| D0240 | <1% | 857 | $10K | |
| D0220 | Intraoral - periapical first radiographic image | <1% | 460 | $4K |
| D1110 | Prophylaxis - adult | <1% | 132 | $3K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | <1% | 19 | $2K |
| D0330 | Panoramic radiographic image | <1% | 48 | $2K |
| D2330 | <1% | 22 | $2K | |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 119 | $1K |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 12 | $98.80 |
| D1354 | 0% | 26 | $0.00 |
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 officialHANKS, JONATHAN (ONWER/DDS)
| Provider | Location | Paid |
|---|---|---|
| Winona Pediatric Dentistry LLC | Winona, MN | $4K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.