Boutique Dental

Boutique Dental was paid $871.82 by Medicaid between Aug 2019 and Jul 2020, across 3 billing codes. Its largest line is D0220, Intraoral - periapical first radiographic image — 60% of everything it billed.

33Billing provider infoBOUTIQUE DENTAL
GLENDALE, NY 11385

33aNPI1285079962assigned 05/07/2013

33bProvider typeDental Clinic/Center

28Total paid$871.82

24GClaims92

24DCodes billed3

24AFirst – last monthAug 2019 – Jul 2020

Compared with peers

Next to other Dental Clinic/Center providers in New York

Rank by total paid#177 of 188

Median peer was paid$113K

This provider vs. median0.0×

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	25	$339.38
2020	67	$532.44

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0220	Intraoral - periapical first radiographic image	60%	53	53	$522.58
D0150	Comprehensive oral evaluation - new or established patient	24%	12	12	$211.20
D0230	Intraoral - periapical each additional radiographic image	16%	27	27	$138.04

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 officialMULLAKANDOVA, YELENA (OWNER/DENTIST)