GRACE DENTAL STUDIO, LLC
NPI: 1497912372
· GLENDALE, NY 11385
· Dental Clinic/Center
· NPI assigned 05/19/2008
Provider Details
| Authorized Official | HAN, GRACE (MEMBER) |
| NPI Enumeration Date | 05/19/2008 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
52 |
$836.00 |
| 2021 |
543 |
$11K |
| 2022 |
472 |
$8K |
| 2023 |
168 |
$3K |
| 2024 |
36 |
$864.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
437 |
436 |
$14K |
| D0274 |
Bitewings - four radiographic images |
313 |
313 |
$4K |
| D0120 |
Periodic oral evaluation - established patient |
199 |
198 |
$4K |
| D0220 |
Intraoral - periapical first radiographic image |
152 |
150 |
$928.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
134 |
134 |
$524.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
24 |
24 |
$504.00 |
| D0330 |
Panoramic radiographic image |
12 |
12 |
$308.00 |