Benne, Stacy

Benne, Stacy was paid $1K by Medicaid between Mar 2024 and Mar 2024, across 3 billing codes. Its largest line is D1206, Topical application of fluoride varnish — 39% 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
2024incomplete	50	$1K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1206	Topical application of fluoride varnish	39%	18	18	$432.00
D1120	Dental cleaning, childProphylaxis - child	36%	13	13	$403.00
D0190		25%	19	19	$285.00

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.