Zaciewski, Samantha

Zaciewski, Samantha was paid $2K by Medicaid between Mar 2018 and Apr 2021, across 2 billing codes. Its largest line is D1110, Prophylaxis - adult — 77% of everything it billed.

33Billing provider infoZACIEWSKI, SAMANTHA
TIFFIN, OH 44883

33aNPI1215082342assigned 01/25/2007

33bProvider typeGeneral Practice Dentistry

28Total paid$2K

24GClaims67

24DCodes billed2

24AFirst – last monthMar 2018 – Apr 2021

Compared with peers

Next to other General Practice Dentistry providers in Ohio

Rank by total paid#728 of 870

Median peer was paid$40K

This provider vs. median0.0×

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	12	$430.08
2021	55	$1K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1110	Prophylaxis - adult	77%	40	39	$1K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	23%	27	26	$388.54

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.