Radefeld, Jaclyn

Radefeld, Jaclyn was paid $9K by Medicaid between Jan 2018 and Oct 2018, across 9 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 24% of everything it billed.

33Billing provider infoRADEFELD, JACLYN
PARMA, OH 44129

33aNPI1477927457assigned 11/13/2015

33bProvider typeGeneral Practice Dentistry

28Total paid$9K

24GClaims509

24DCodes billed9

24AFirst – last monthJan 2018 – Oct 2018

Compared with peers

Next to other General Practice Dentistry providers in Ohio

Rank by total paid#600 of 870

Median peer was paid$40K

This provider vs. median0.2×

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	509	$9K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	24%	39	15	$2K
D1120	Dental cleaning, childProphylaxis - child	23%	105	105	$2K
D1208	Topical application of fluoride, excluding varnish	17%	99	99	$1K
D0150	Comprehensive oral evaluation - new or established patient	16%	55	55	$1K
D0272	Bitewings - two radiographic images	8.5%	76	76	$740.00
D0230	Intraoral - periapical each additional radiographic image	3.2%	55	51	$275.00
D0220	Intraoral - periapical first radiographic image	3.0%	53	53	$265.00
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	2.7%	15	15	$239.12
D1206	Topical application of fluoride varnish	2.1%	12	12	$180.00

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.