GRACE DENTAL OF VIRGINIA, LLC
NPI: 1700212511
· CHANTILLY, VA 20151
· General Practice Dentistry
· NPI assigned 09/25/2013
Provider Details
| Authorized Official | JARWA, SAMER (DENTIST) |
| NPI Enumeration Date | 09/25/2013 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
76 |
$3K |
| 2022 |
989 |
$41K |
| 2023 |
1,840 |
$39K |
| 2024 |
1,152 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9248 |
|
458 |
446 |
$26K |
| D9920 |
|
480 |
464 |
$17K |
| D4910 |
|
468 |
456 |
$15K |
| D0120 |
Periodic oral evaluation - established patient |
778 |
761 |
$9K |
| D9630 |
|
687 |
672 |
$7K |
| D9994 |
|
920 |
896 |
$4K |
| D1110 |
Prophylaxis - adult |
127 |
126 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
42 |
42 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
55 |
53 |
$203.42 |
| D0230 |
Intraoral - periapical each additional radiographic image |
25 |
25 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
17 |
17 |
$0.00 |