Ellerhorst Dental, LLC

Ellerhorst Dental, LLC was paid $14K by Medicaid between Aug 2024 and Dec 2024, across 8 billing codes. Its largest line is D0150, Comprehensive oral evaluation - new or established patient — 48% of everything it billed.

33Billing provider infoELLERHORST DENTAL, LLC
MANTUA, OH 44255

33aNPI1740035468assigned 04/17/2024

33bProvider typeDental Clinic/Center

28Total paid$14K

24GClaims340

24DCodes billed8

24AFirst – last monthAug 2024 – Dec 2024

Compared with peers

Next to other Dental Clinic/Center providers in Ohio

Rank by total paid#93 of 111

Median peer was paid$236K

This provider vs. median0.1×

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
2024incomplete	340	$14K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0150	Comprehensive oral evaluation - new or established patient	48%	136	128	$7K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	15%	24	12	$2K
D1206	Topical application of fluoride varnish	12%	63	62	$2K
D1120	Dental cleaning, childProphylaxis - child	8.0%	31	30	$1K
D1110	Prophylaxis - adult	7.8%	18	18	$1K
D0274	Bitewings - four radiographic images	4.6%	18	18	$642.90
D0220	Intraoral - periapical first radiographic image	2.6%	37	32	$361.20
D0272	Bitewings - two radiographic images	1.8%	13	13	$255.45

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 officialELLERHORST, LYDIA (DENTIST/OWNER)