Dental
Evalt, Levi
Evalt, Levi was paid $108K by Medicaid between Jan 2021 and Dec 2024, across 12 billing codes. Its largest line is D0330, Panoramic radiographic image — 20% of everything it billed.
33Billing provider infoEVALT, LEVI
CORRY, PA 16407
CORRY, PA 16407
33aNPI1942488952assigned 02/01/2008
33bProvider typeGeneral Practice Dentistry
28Total paid$108K
24GClaims3,457
24DCodes billed12
24AFirst – last monthJan 2021 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in Pennsylvania
Rank by total paid#258 of 847
Median peer was paid$37K
This provider vs. median2.9×
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 | |
|---|---|---|---|
| 2021 | 1,939 | $61K | |
| 2024incomplete | 1,518 | $47K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0330 | Panoramic radiographic image | 20% | 621 | 620 | $22K |
| D1110 | Prophylaxis - adult | 18% | 557 | 552 | $19K |
| D0274 | Bitewings - four radiographic images | 16% | 655 | 653 | $17K |
| D7140 | Extraction, erupted tooth or exposed root | 13% | 221 | 29 | $14K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 12% | 224 | 96 | $13K |
| D0150 | Comprehensive oral evaluation - new or established patient | 7.5% | 424 | 423 | $8K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 6.7% | 385 | 383 | $7K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 3.0% | 66 | 32 | $3K |
| D1208 | Topical application of fluoride, excluding varnish | 2.0% | 116 | 116 | $2K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 1.1% | 22 | 15 | $1K |
| D0220 | Intraoral - periapical first radiographic image | <1% | 140 | 136 | $896.00 |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 26 | 26 | $320.00 |
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.