Grajevskaja, Viktorija

Grajevskaja, Viktorija was paid $203K by Medicaid between Jan 2024 and Dec 2024, across 10 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 99% of everything it billed.

33Billing provider infoGRAJEVSKAJA, VIKTORIJA
PORT ALLEGANY, PA 16743

33aNPI1730752619assigned 07/20/2021

33bProvider typeDentist

28Total paid$203K

24GClaims3,686

24DCodes billed10

24AFirst – last monthJan 2024 – Dec 2024

Compared with peers

Next to other Dentist providers in Pennsylvania

Rank by total paid#122 of 683

Median peer was paid$34K

This provider vs. median5.9×

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
2024incomplete	3,686	$203K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
T1015	A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive	99%	1,099	992	$201K
D1120	Dental cleaning, childProphylaxis - child	<1%	395	394	$500.37
D1206	Topical application of fluoride varnish	<1%	506	505	$357.12
D1110	Prophylaxis - adult	<1%	416	416	$238.61
D0330	Panoramic radiographic image	<1%	168	168	$179.88
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	<1%	245	245	$102.84
D0274	Bitewings - four radiographic images	<1%	221	221	$92.16
D0220	Intraoral - periapical first radiographic image	<1%	332	328	$90.42
D0272	Bitewings - two radiographic images	<1%	107	107	$69.66
D0230	Intraoral - periapical each additional radiographic image	<1%	197	193	$46.26

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.