Grandville, Thomas

Grandville, Thomas was paid $198K by Medicaid between Jan 2018 and Oct 2024, across 9 billing codes. Its largest line is D1120, dental cleaning, child — 38% of everything it billed.

33Billing provider infoGRANDVILLE, THOMAS
PORT JEFFERSON STATION, NY 11776

33aNPI1487949236assigned 06/09/2011

33bProvider typePediatric Dentist

28Total paid$198K

24GClaims7,051

24DCodes billed9

24AFirst – last monthJan 2018 – Oct 2024

Compared with peers

Next to other Pediatric Dentist providers in New York

Rank by total paid#255 of 514

Median peer was paid$196K

This provider vs. median1.0×

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
2018	1,411	$39K
2019	888	$25K
2020	958	$27K
2021	1,282	$35K
2022	985	$28K
2023	878	$25K
2024incomplete	649	$18K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1120	Dental cleaning, childProphylaxis - child	38%	1,762	1,762	$76K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	34%	2,339	2,339	$68K
D1208	Topical application of fluoride, excluding varnish	16%	2,287	2,287	$32K
D1110	Prophylaxis - adult	5.8%	200	200	$12K
D0272	Bitewings - two radiographic images	2.9%	336	336	$6K
D7140	Extraction, erupted tooth or exposed root	1.3%	38	26	$3K
D0274	Bitewings - four radiographic images	<1%	50	50	$1K
D2150	Silver amalgam - two surfaces, primary or permanent	<1%	15	12	$1K
D0220	Intraoral - periapical first radiographic image	<1%	24	24	$312.00

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.