Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › WI › LA CROSSE › COULEE FAMILY DENTAL LLC

COULEE FAMILY DENTAL LLC

NPI: 1922401280 · LA CROSSE, WI 54601 · Dentist · NPI assigned 10/01/2014

$4K
Total Medicaid Paid
182
Total Claims
173
Beneficiaries
3
Codes Billed
2018-02
First Month
2024-06
Last Month

Provider Details

Authorized OfficialJONES, CHRISTINE (DENTIST)
NPI Enumeration Date10/01/2014

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 31 $615.42
2019 13 $331.63
2021 59 $1K
2022 35 $680.73
2023 30 $565.11
2024 14 $262.59

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0120 Periodic oral evaluation - established patient 100 96 $2K
D1110 Prophylaxis - adult 68 64 $2K
D1206 Topical application of fluoride varnish 14 13 $234.65