Bouz, Sviatoslav

Bouz, Sviatoslav was paid $57K by Medicaid between Jan 2019 and Mar 2021, across 12 billing codes. Its largest line is D1110, Prophylaxis - adult — 16% of everything it billed.

33Billing provider infoBOUZ, SVIATOSLAV
CLEVELAND, TN 37312

33aNPI1831676386assigned 07/26/2018

33bProvider typeDentist

28Total paid$57K

24GClaims1,993

24DCodes billed12

24AFirst – last monthJan 2019 – Mar 2021

Compared with peers

Next to other Dentist providers in Tennessee

Rank by total paid#174 of 242

Median peer was paid$164K

This provider vs. median0.3×

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
2019	1,008	$31K
2020	828	$21K
2021	157	$5K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1110	Prophylaxis - adult	16%	225	215	$9K
D0150	Comprehensive oral evaluation - new or established patient	16%	319	307	$9K
D2391	Resin-based composite - one surface, posterior, primary or permanent	15%	159	59	$9K
D1120	Dental cleaning, childProphylaxis - child	13%	242	236	$7K
D1206	Topical application of fluoride varnish	9.1%	262	260	$5K
D0330	Panoramic radiographic image	8.6%	198	191	$5K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	7.1%	176	173	$4K
D0274	Bitewings - four radiographic images	6.4%	180	173	$4K
D1208	Topical application of fluoride, excluding varnish	3.8%	107	101	$2K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	2.6%	23	13	$1K
D0272	Bitewings - two radiographic images	2.5%	88	87	$1K
D0220	Intraoral - periapical first radiographic image	<1%	14	14	$127.30

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.