GRAND LAKE FAMILY DENTISTRY, LTD.
NPI: 1952428310
· CELINA, OH 45822
· Dentist
· NPI assigned 03/23/2007
Provider Details
| Authorized Official | LUTZ, TRAVIS (PRESIDENT) |
| NPI Enumeration Date | 03/23/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,632 |
$35K |
| 2019 |
550 |
$10K |
| 2020 |
369 |
$7K |
| 2021 |
445 |
$9K |
| 2022 |
543 |
$11K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
648 |
493 |
$22K |
| D0120 |
Periodic oral evaluation - established patient |
1,191 |
926 |
$20K |
| D1206 |
Topical application of fluoride varnish |
571 |
515 |
$9K |
| D1120 |
Prophylaxis - child |
404 |
290 |
$8K |
| D1208 |
Topical application of fluoride, excluding varnish |
388 |
227 |
$6K |
| D0274 |
Bitewings - four radiographic images |
158 |
96 |
$3K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
48 |
12 |
$3K |
| D0272 |
Bitewings - two radiographic images |
103 |
70 |
$1K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
28 |
16 |
$771.76 |