Grigory Rozenvich D.D.S., INC.

Grigory Rozenvich D.D.S., INC. was paid $38K by Medicaid between Feb 2018 and Dec 2022, across 9 billing codes. Its largest line is D0120, dental checkup, returning patient — 53% of everything it billed.

33Billing provider infoGRIGORY ROZENVICH D.D.S., INC.
SANTA ANA, CA 92704

33aNPI1912196171assigned 10/23/2007

33bProvider typeExclusive Provider Organization

28Total paid$38K

24GClaims1,479

24DCodes billed9

24AFirst – last monthFeb 2018 – Dec 2022

Compared with peers

Next to other Exclusive Provider Organization providers in California

Rank by total paid#35 of 55

Median peer was paid$90K

This provider vs. median0.4×

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
2018	461	$11K
2019	575	$17K
2020	254	$6K
2021	101	$3K
2022	88	$2K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	53%	499	499	$20K
D1120	Dental cleaning, childProphylaxis - child	13%	171	170	$5K
D1208	Topical application of fluoride, excluding varnish	12%	422	420	$5K
D0274	Bitewings - four radiographic images	12%	210	210	$4K
D0150	Comprehensive oral evaluation - new or established patient	3.1%	18	18	$1K
D4910		2.6%	13	13	$1K
D0210	Intraoral - complete series of radiographic images	1.5%	12	12	$576.00
D0230	Intraoral - periapical each additional radiographic image	1.3%	116	40	$486.00
D0350		<1%	18	13	$182.40

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 officialROZENOVICH, GRIGORY (PRESIDENT)