Dental
Children's Specialty Group, INC.
Children's Specialty Group, INC. was paid $10.36M by Medicaid between Jan 2024 and Dec 2024, across 150 billing codes. Its largest line is 99284, emergency room visit (serious) — 20% of everything it billed.
33Billing provider infoCHILDREN'S SPECIALTY GROUP, INC.
MILWAUKEE, WI 53226
MILWAUKEE, WI 53226
33aNPI1942970405assigned 09/16/2021
33bProvider typePediatric Dentist
28Total paid$10.36M
24GClaims183,077
24DCodes billed150
24AFirst – last monthJan 2024 – Dec 2024
Compared with peers
Next to other Pediatric Dentist providers in Wisconsin
Rank by total paid#3 of 61
Median peer was paid$85K
This provider vs. median122×
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 CADIEUX, MARC controls 13+ 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 | |
|---|---|---|---|
| 2024incomplete | 183,077 | $10.36M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 20% | 14,206 | 13,313 | $2.10M |
| 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 | 14% | 19,732 | 17,811 | $1.43M |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 10% | 11,922 | 10,978 | $1.08M |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 9.1% | 19,547 | 18,518 | $939K |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 6.8% | 3,514 | 3,312 | $702K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 4.6% | 9,641 | 8,876 | $475K |
| 99244 | Office or other outpatient consultation, moderate to high complexity | 2.4% | 2,593 | 2,312 | $253K |
| 70551 | Magnetic resonance imaging, brain; without contrast material | 1.5% | 2,674 | 2,438 | $160K |
| 95720 | 1.5% | 1,301 | 961 | $151K | |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 1.4% | 1,678 | 1,563 | $148K |
| 69436 | Tympanostomy (requiring insertion of ventilating tube), general anesthesia | 1.3% | 561 | 534 | $135K |
| 92060 | 1.3% | 4,037 | 3,481 | $132K |
138 more codes
| 99472 | Subsequent inpatient pediatric critical care, per day, 2-5 years | 1.3% | 421 | $130K |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 1.2% | 2,239 | $130K |
| 00170 | Anesthesia for intraoral procedures, including biopsy | 1.2% | 1,057 | $125K |
| 99239 | Hospital discharge day management, more than 30 minutes | 1.2% | 1,852 | $122K |
| 99204 | Doctor's office visit, new patient (more involved) | 1.1% | 1,041 | $118K |
| 99233 | Hospital visit by a doctor, follow-up day (complex) | <1% | 3,333 | $97K |
| 99243 | <1% | 1,171 | $81K | |
| 93303 | Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study | <1% | 1,476 | $74K |
| 70553 | Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences | <1% | 758 | $71K |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 1,030 | $71K |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | <1% | 2,225 | $63K |
| 99245 | <1% | 493 | $63K | |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 730 | $57K |
| 42820 | Tonsillectomy and adenoidectomy; younger than age 12 | <1% | 265 | $56K |
| 96116 | <1% | 904 | $55K | |
| 01922 | <1% | 506 | $55K | |
| 70450 | Computed tomography, head or brain; without contrast material | <1% | 1,341 | $54K |
| 96132 | <1% | 656 | $53K | |
| 71045 | Radiologic examination, chest; single view | <1% | 9,139 | $49K |
| 96139 | <1% | 530 | $47K | |
| 92015 | Determination of refractive state | <1% | 5,259 | $42K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 5,622 | $42K |
| 96133 | <1% | 428 | $39K | |
| 93320 | <1% | 1,658 | $35K | |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 4,587 | $33K |
| 96167 | <1% | 726 | $33K | |
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | <1% | 371 | $30K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | <1% | 805 | $29K |
| 76770 | <1% | 991 | $28K | |
| 93976 | <1% | 577 | $26K | |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | <1% | 527 | $26K |
| 99205 | Prolong outpt/office vis | <1% | 151 | $26K |
| 74018 | <1% | 4,250 | $25K | |
| 64642 | <1% | 554 | $24K | |
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 1,154 | $24K |
| 96158 | <1% | 590 | $24K | |
| 64643 | <1% | 521 | $24K | |
| 76775 | <1% | 792 | $22K | |
| 94010 | <1% | 2,047 | $21K | |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | <1% | 401 | $20K |
| 99223 | Prolong inpt eval add15 m | <1% | 329 | $20K |
| 99242 | <1% | 385 | $19K | |
| G0316 | Prolonged hospital inpatient or observation care evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99223, 99233, and 99236 for hospital inpatient or observation care evaluation and management services). (do not report g0316 on the same date of service as other prolonged services for evaluation and management 99358, 99359, 99418, 99415, 99416). (do not report g0316 for any time unit less than 15 minutes) | <1% | 303 | $17K |
| 76506 | <1% | 557 | $17K | |
| 96156 | <1% | 219 | $16K | |
| 99480 | Subsequent intensive care, per day, low birth weight infant | <1% | 159 | $16K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | <1% | 39 | $14K |
| 93325 | <1% | 3,467 | $13K | |
| 96138 | <1% | 590 | $13K | |
| 72148 | Magnetic resonance imaging, lumbar spine; without contrast material | <1% | 185 | $12K |
| 73610 | <1% | 1,342 | $12K | |
| 73630 | <1% | 1,327 | $11K | |
| 96136 | <1% | 375 | $11K | |
| 95004 | Percutaneous tests with allergenic extracts, immediate type reaction | <1% | 362 | $11K |
| 95718 | <1% | 147 | $11K | |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | <1% | 310 | $11K |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | <1% | 303 | $10K |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 569 | $9K |
| 73590 | <1% | 1,115 | $9K | |
| 95719 | <1% | 90 | $9K | |
| 73090 | <1% | 1,100 | $9K | |
| G2212 | Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99205, 99215, 99483 for office or other outpatient evaluation and management services) (do not report g2212 on the same date of service as 99358, 99359, 99415, 99416). (do not report g2212 for any time unit less than 15 minutes) | <1% | 224 | $8K |
| 72141 | <1% | 116 | $7K | |
| 92504 | <1% | 373 | $7K | |
| 95874 | <1% | 716 | $7K | |
| 00731 | <1% | 131 | $7K | |
| 73721 | Magnetic resonance imaging, any joint of lower extremity; without contrast material | <1% | 160 | $7K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 210 | $7K |
| 92201 | <1% | 441 | $7K | |
| 74019 | <1% | 847 | $7K | |
| 72082 | <1% | 664 | $7K | |
| 73140 | <1% | 1,063 | $7K | |
| 90837 | Psychotherapy session, about an hour | <1% | 57 | $7K |
| 88342 | <1% | 228 | $6K | |
| 70486 | <1% | 114 | $6K | |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 115 | $6K |
| 72170 | <1% | 850 | $6K | |
| 72081 | <1% | 707 | $6K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 91 | $5K |
| 73560 | <1% | 703 | $5K | |
| 96112 | <1% | 70 | $5K | |
| 73070 | <1% | 778 | $5K | |
| 72146 | <1% | 67 | $5K | |
| 95782 | <1% | 40 | $5K | |
| 73100 | <1% | 638 | $5K | |
| 85060 | <1% | 304 | $5K | |
| 73130 | <1% | 549 | $4K | |
| 95251 | <1% | 208 | $4K | |
| 93356 | <1% | 175 | $4K | |
| 96168 | <1% | 182 | $4K | |
| 88307 | <1% | 48 | $3K | |
| 88108 | <1% | 299 | $3K | |
| 00126 | <1% | 56 | $3K | |
| 93321 | <1% | 580 | $3K | |
| 96131 | <1% | 12 | $3K | |
| 76536 | <1% | 115 | $3K | |
| 95813 | <1% | 61 | $3K | |
| 88304 | <1% | 272 | $3K | |
| 95819 | <1% | 111 | $3K | |
| 42830 | <1% | 15 | $3K | |
| 93308 | <1% | 163 | $3K | |
| 80503 | <1% | 195 | $3K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 307 | $2K |
| 95717 | <1% | 35 | $2K | |
| 17110 | <1% | 99 | $2K | |
| 96137 | <1% | 12 | $2K | |
| 70360 | <1% | 309 | $2K | |
| 99292 | <1% | 53 | $2K | |
| 73110 | <1% | 263 | $2K | |
| 76700 | Ultrasound, abdominal, real time with image documentation; complete | <1% | 44 | $2K |
| 71260 | Computed tomography, thorax, diagnostic; with contrast material | <1% | 40 | $2K |
| 73552 | <1% | 231 | $1K | |
| 91200 | <1% | 148 | $1K | |
| 95816 | <1% | 51 | $1K | |
| 96130 | <1% | 12 | $1K | |
| 96159 | <1% | 46 | $1K | |
| 88312 | <1% | 24 | $1K | |
| 77073 | <1% | 108 | $980.95 | |
| 99253 | <1% | 15 | $909.44 | |
| 99254 | <1% | 13 | $891.04 | |
| 77072 | <1% | 149 | $839.13 | |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | <1% | 41 | $678.38 |
| 70543 | <1% | 14 | $670.48 | |
| 72040 | <1% | 69 | $635.90 | |
| 92250 | <1% | 29 | $633.64 | |
| 74230 | <1% | 33 | $627.67 | |
| 76825 | <1% | 12 | $585.22 | |
| 93304 | <1% | 24 | $559.72 | |
| 74240 | <1% | 18 | $554.52 | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 15 | $482.56 |
| 76827 | <1% | 12 | $322.82 | |
| 73564 | <1% | 20 | $198.69 | |
| 70250 | <1% | 13 | $130.24 | |
| 72100 | <1% | 12 | $126.00 | |
| 76010 | <1% | 12 | $114.95 | |
| 73030 | <1% | 13 | $87.24 | |
| 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) | 0% | 164 | $0.00 |
| 99358 | Prolong nursin fac eval 15m | 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 officialCADIEUX, MARC (CORPORATE VP & CFO)
| Provider | Location | Paid |
|---|---|---|
| Children's Hospital and Health System, INC. | Milwaukee, WI | $17.92M |
| Surgicenter of Greater Milwaukee, LLC | Milwaukee, WI | $4.44M |
| Children's Hospital of Wisconsin, INC. | Neenah, WI | $3.37M |
| Children's Health System | Milwaukee, WI | $2.34M |
| Children's Health System, INC. | Kenosha, WI | $1.81M |
| Children's Health System | Milwaukee, WI | $651K |
| Children's Health System | New Berlin, WI | $370K |
| Children's Hospital of Wisconsin, INC. | Milwaukee, WI | $148K |
| Children's Health System | Mequon, WI | $93K |
| Children's Health System, INC. | Oak Creek, WI | $88K |
| Children's Hospital of Wisconsin, INC. | Milwaukee, WI | $66K |
| Children's Health System | Delafield, WI | $23K |
| West Allis Prescription Center INC | West Allis, WI | $15K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.