Clinic
Gundersen Clinic LTD
Gundersen Clinic LTD was paid $10.13M by Medicaid between Jan 2018 and Dec 2024, across 136 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 23% of everything it billed.
33Billing provider infoGUNDERSEN CLINIC LTD
LA CROSSE, WI 54601
LA CROSSE, WI 54601
33aNPI1851343115assigned 05/16/2006
33bProvider typeDental Clinic/Center
28Total paid$10.13M
24GClaims357,259
24DCodes billed136
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Dental Clinic/Center providers in Wisconsin
Rank by total paid#5 of 51
Median peer was paid$1.07M
This provider vs. median9.4×
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official ADANK, KARI controls 16+ related entities in our dataset. Read more
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 | 63,404 | $1.42M | |
| 2019 | 55,948 | $1.45M | |
| 2020 | 35,863 | $954K | |
| 2021 | 50,773 | $1.36M | |
| 2022 | 51,970 | $1.64M | |
| 2023 | 55,033 | $1.80M | |
| 2024incomplete | 44,268 | $1.50M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 23% | 55,784 | 50,472 | $2.33M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 16% | 52,979 | 48,184 | $1.62M |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 9.9% | 27,363 | 25,407 | $1.00M |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 5.9% | 15,018 | 10,097 | $593K |
| D7140 | Extraction, erupted tooth or exposed root | 5.7% | 14,574 | 3,191 | $578K |
| 92340 | Fitting of spectacles, except for aphakia; monofocal | 4.4% | 22,897 | 21,745 | $444K |
| 92015 | Determination of refractive state | 3.9% | 45,233 | 41,164 | $394K |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 3.6% | 9,628 | 8,700 | $367K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 2.6% | 1,551 | 550 | $259K |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | 2.1% | 7,120 | 5,510 | $213K |
| D8670 | Periodic orthodontic treatment visit | 1.9% | 1,093 | 1,078 | $196K |
| D0140 | Limited oral evaluation - problem focused | 1.5% | 7,913 | 7,195 | $151K |
124 more codes
| 90837 | Psychotherapy session, about an hour | 1.5% | 2,036 | $147K |
| D1120 | Dental cleaning, child | 1.4% | 5,786 | $144K |
| D0120 | Dental checkup, returning patient | 1.1% | 6,574 | $116K |
| D1206 | Topical application of fluoride varnish | 1.1% | 7,689 | $115K |
| D9222 | <1% | 1,362 | $92K | |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | <1% | 4,070 | $88K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | <1% | 1,114 | $87K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 2,021 | $82K |
| 99284 | Emergency room visit (serious) | <1% | 3,431 | $77K |
| D9223 | Deep sedation/general anesthesia - each subsequent 15 minute increment | <1% | 1,374 | $74K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | <1% | 1,473 | $66K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 7,310 | $65K |
| 92341 | <1% | 2,153 | $55K | |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 2,279 | $55K |
| D7240 | Removal of impacted tooth - completely bony | <1% | 257 | $54K |
| 90686 | <1% | 4,928 | $50K | |
| D1351 | Sealant - per tooth | <1% | 2,527 | $49K |
| D0272 | Bitewings - two radiographic images | <1% | 3,147 | $48K |
| D7230 | <1% | 212 | $41K | |
| 99285 | Emergency room visit (most serious) | <1% | 1,297 | $38K |
| 11721 | <1% | 3,076 | $38K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 1,242 | $26K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 421 | $25K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 417 | $24K |
| D1110 | Prophylaxis - adult | <1% | 840 | $24K |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 891 | $21K |
| D0330 | Panoramic radiographic image | <1% | 414 | $19K |
| D0220 | Intraoral - periapical first radiographic image | <1% | 1,585 | $16K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 259 | $16K |
| 3008F | <1% | 1,996 | $14K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 200 | $13K |
| V2020 | Frames, purchases | <1% | 1,192 | $12K |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 332 | $11K |
| 99283 | Emergency room visit (moderate) | <1% | 608 | $11K |
| 99460 | <1% | 117 | $10K | |
| 99334 | <1% | 235 | $8K | |
| 99347 | <1% | 276 | $8K | |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | <1% | 452 | $8K |
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 555 | $8K |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | <1% | 5,016 | $7K |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 542 | $7K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | <1% | 60 | $7K |
| 36415 | Collection of venous blood by venipuncture | <1% | 6,944 | $7K |
| D0210 | Intraoral - complete series of radiographic images | <1% | 119 | $6K |
| 90688 | <1% | 394 | $6K | |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 95 | $6K |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | <1% | 260 | $5K |
| 90791 | Psychiatric diagnostic evaluation | <1% | 75 | $5K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 110 | $5K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 79 | $4K |
| 92250 | <1% | 347 | $4K | |
| 90961 | <1% | 76 | $4K | |
| 82565 | <1% | 887 | $4K | |
| T1015 | A visit at a community health center or clinic (one all-in rate) | <1% | 33 | $3K |
| V2025 | Deluxe frame | <1% | 517 | $2K |
| D9243 | <1% | 65 | $2K | |
| 90836 | <1% | 45 | $2K | |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | <1% | 454 | $2K |
| 90662 | <1% | 50 | $2K | |
| 92133 | <1% | 101 | $2K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 177 | $2K |
| 99310 | Prolong nursin fac eval 15m | <1% | 14 | $2K |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 157 | $2K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 54 | $1K |
| 20610 | <1% | 32 | $1K | |
| 85610 | <1% | 779 | $1K | |
| 99223 | Prolong inpt eval add15 m | <1% | 44 | $1K |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 18 | $1K |
| D9239 | <1% | 47 | $1K | |
| 99349 | <1% | 58 | $1K | |
| 90656 | <1% | 78 | $1K | |
| D2941 | <1% | 21 | $1K | |
| 92134 | <1% | 71 | $1K | |
| 71046 | Radiologic examination, chest; 2 views | <1% | 141 | $1K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 13 | $1K |
| 90960 | End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits | <1% | 24 | $982.39 |
| 99442 | <1% | 30 | $865.39 | |
| J1050 | Injection, medroxyprogesterone acetate, 1 mg | <1% | 12 | $792.75 |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | <1% | 15 | $734.08 |
| 99233 | Hospital visit by a doctor, follow-up day (complex) | <1% | 75 | $732.37 |
| 90672 | <1% | 26 | $694.37 | |
| G0008 | Administration of influenza virus vaccine | <1% | 166 | $635.53 |
| 84460 | <1% | 110 | $552.06 | |
| 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | <1% | 26 | $496.96 |
| 0001A | <1% | 13 | $496.08 | |
| 90734 | <1% | 12 | $473.89 | |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | <1% | 16 | $441.00 |
| 92557 | <1% | 15 | $430.05 | |
| 76819 | Fetal biophysical profile; without non-stress testing | <1% | 15 | $403.78 |
| 92567 | <1% | 29 | $393.87 | |
| 90670 | <1% | 114 | $377.34 | |
| 92083 | <1% | 20 | $327.23 | |
| 99220 | <1% | 14 | $302.84 | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 40 | $297.25 |
| 0124A | <1% | 12 | $281.17 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 71 | $267.56 |
| 73630 | <1% | 31 | $255.28 | |
| 99443 | <1% | 19 | $225.12 | |
| 85027 | <1% | 42 | $223.47 | |
| 94010 | <1% | 22 | $217.98 | |
| 84132 | <1% | 68 | $210.03 | |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 14 | $206.90 |
| 92136 | <1% | 16 | $205.91 | |
| 90785 | <1% | 22 | $198.88 | |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 30 | $194.42 |
| 90685 | <1% | 60 | $188.67 | |
| 90698 | <1% | 55 | $182.05 | |
| 90651 | <1% | 12 | $153.31 | |
| 90633 | <1% | 43 | $119.16 | |
| J1040 | Injection, methylprednisolone acetate, 80 mg | <1% | 12 | $113.59 |
| 99441 | <1% | 17 | $107.64 | |
| 95117 | <1% | 18 | $74.25 | |
| 84295 | <1% | 13 | $48.10 | |
| 90680 | <1% | 13 | $43.03 | |
| 90648 | <1% | 12 | $39.72 | |
| 84520 | <1% | 13 | $27.65 | |
| V2784 | Lens, polycarbonate or equal, any index, per lens | <1% | 336 | $7.76 |
| D0145 | Oral evaluation for a patient under three years of age | 0% | 26 | $0.00 |
| 91300 | 0% | 45 | $0.00 | |
| V2203 | Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 0% | 127 | $0.00 |
| 99358 | Prolong nursin fac eval 15m | 0% | 17 | $0.00 |
| V2104 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens | 0% | 18 | $0.00 |
| J3490 | Unclassified drugs | 0% | 17 | $0.00 |
| 91301 | 0% | 12 | $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 officialADANK, KARI (CCO)
| Provider | Location | Paid |
|---|---|---|
| Gundersen Lutheran Medical Center INC | La Crosse, WI | $74.27M |
| Gundersen Lutheran Medical Center, INC. | La Crosse, WI | $1.96M |
| Gundersen Lutheran Medical Center INC | Onalaska, WI | $1.63M |
| Gundersen Clinic, LTD. | Lansing, IA | $379K |
| Gundersen Lutheran Medical Center INC | Viroqua, WI | $375K |
| Gundersen Lutheran Medical Center INC | Tomah, WI | $201K |
| Gundersen Lutheran Medical Center INC | Winona, MN | $89K |
| Gundersen Regional Clinics, LLC | Decorah, IA | $70K |
| Gundersen Lutheran Medical Center, INC | La Crosse, WI | $28K |
| Gundersen Clinic LTD | Spring Grove, MN | $2K |
| Gundersen Lutheran Medical Center, INC | Onalaska, WI | $2K |
| Gundersen Clinic, LTD. | Houston, MN | $977.31 |
| Gundersen Lutheran Medical Center, INC | La Crosse, WI | $827.41 |
| Gundersen Clinic LTD | Harmony, MN | $11.17 |
| Gundersen Lutheran Medical Center, INC. | La Crosse, WI | $0.00 |
| Gundersen Clinic, LTD. | Independence, WI | $0.00 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.