Dental
Grand Lake Family Dentistry, LTD.
Grand Lake Family Dentistry, LTD. was paid $73K by Medicaid between Jan 2018 and Dec 2022, across 9 billing codes. Its largest line is D1110, Prophylaxis - adult — 30% of everything it billed.
33Billing provider infoGRAND LAKE FAMILY DENTISTRY, LTD.
CELINA, OH 45822
CELINA, OH 45822
33aNPI1952428310assigned 03/23/2007
33bProvider typeDentist
28Total paid$73K
24GClaims3,539
24DCodes billed9
24AFirst – last monthJan 2018 – Dec 2022
Compared with peers
Next to other Dentist providers in Ohio
Rank by total paid#307 of 745
Median peer was paid$38K
This provider vs. median1.9×
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 | |
|---|---|---|---|
| 2018 | 1,632 | $35K | |
| 2019 | 550 | $10K | |
| 2020 | 369 | $7K | |
| 2021 | 445 | $9K | |
| 2022 | 543 | $11K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 30% | 648 | 493 | $22K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 28% | 1,191 | 926 | $20K |
| D1206 | Topical application of fluoride varnish | 12% | 571 | 515 | $9K |
| D1120 | Dental cleaning, childProphylaxis - child | 11% | 404 | 290 | $8K |
| D1208 | Topical application of fluoride, excluding varnish | 8.3% | 388 | 227 | $6K |
| D0274 | Bitewings - four radiographic images | 4.1% | 158 | 96 | $3K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 3.7% | 48 | 12 | $3K |
| D0272 | Bitewings - two radiographic images | 1.5% | 103 | 70 | $1K |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.1% | 28 | 16 | $771.76 |
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 officialLUTZ, TRAVIS (PRESIDENT)