SETIAWAN, GRACE
NPI: 1659524452
· MESQUITE, TX 75150
· Dentist
· NPI assigned 10/24/2008
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
141 |
$758.59 |
| 2024 |
75 |
$2K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0145 |
Oral evaluation for a patient under three years of age |
14 |
14 |
$2K |
| D0230 |
Intraoral - periapical each additional radiographic image |
44 |
12 |
$416.77 |
| D1208 |
Topical application of fluoride, excluding varnish |
25 |
25 |
$367.50 |
| D0220 |
Intraoral - periapical first radiographic image |
12 |
12 |
$150.72 |
| D1999 |
|
27 |
27 |
$0.00 |
| D0603 |
|
94 |
89 |
$0.00 |