DASTMALCHIAN, SHABNAM
NPI: 1023221850
· SAN FERNANDO, CA 91340
· Dentist
· NPI assigned 05/08/2007
$124K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
993 |
$22K |
| 2019 |
558 |
$10K |
| 2020 |
464 |
$14K |
| 2021 |
530 |
$17K |
| 2022 |
624 |
$20K |
| 2023 |
705 |
$19K |
| 2024 |
649 |
$21K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
562 |
561 |
$30K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
373 |
372 |
$21K |
| D0210 |
Intraoral - complete series of radiographic images |
424 |
422 |
$19K |
| D1110 |
Prophylaxis - adult |
230 |
229 |
$17K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,343 |
1,341 |
$16K |
| D1120 |
Prophylaxis - child |
202 |
202 |
$7K |
| D0274 |
Bitewings - four radiographic images |
329 |
328 |
$6K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,006 |
558 |
$4K |
| D4341 |
|
42 |
12 |
$3K |
| D4910 |
|
12 |
12 |
$924.00 |