Rivoli Dental of Glens Falls PC

Rivoli Dental of Glens Falls PC was paid $59K by Medicaid between Jun 2019 and Jul 2021, across 10 billing codes. Its largest line is D1110, Prophylaxis - adult — 35% of everything it billed.

33Billing provider infoRIVOLI DENTAL OF GLENS FALLS PC
GLENS FALLS, NY 12801

33aNPI1609378231assigned 02/28/2018

33bProvider typeGeneral Practice Dentistry

28Total paid$59K

24GClaims2,074

24DCodes billed10

24AFirst – last monthJun 2019 – Jul 2021

Compared with peers

Next to other General Practice Dentistry providers in New York

Rank by total paid#1,054 of 2,184

Median peer was paid$54K

This provider vs. median1.1×

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	128	$4K
2020	1,134	$31K
2021	812	$24K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1110	Prophylaxis - adult	35%	410	406	$21K
D0150	Comprehensive oral evaluation - new or established patient	19%	356	354	$11K
D0274	Bitewings - four radiographic images	14%	282	282	$8K
D2391	Resin-based composite - one surface, posterior, primary or permanent	8.5%	66	44	$5K
D0220	Intraoral - periapical first radiographic image	8.1%	377	373	$5K
D0230	Intraoral - periapical each additional radiographic image	6.1%	366	361	$4K
D9110		2.8%	60	60	$2K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	2.7%	62	62	$2K
D0140	Limited oral evaluation - problem focused	2.2%	82	81	$1K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	1.7%	13	12	$989.82

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 officialZEMBIEC, MAUREEN (INSURANCE MANAGER)