GRACE TYLO LLC
NPI: 1740756345
· ROCKY HILL, CT 06067
· Pediatric Dentist
· NPI assigned 10/22/2018
Provider Details
| Authorized Official | LO, GRACE (DENTIST) |
| NPI Enumeration Date | 10/22/2018 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
30 |
$1K |
| 2024 |
36 |
$1K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
28 |
28 |
$1K |
| D0120 |
Periodic oral evaluation - established patient |
26 |
26 |
$891.80 |
| D1206 |
Topical application of fluoride varnish |
12 |
12 |
$341.04 |