H. Hadidjaja, DDS INC.

H. Hadidjaja, DDS INC. was paid $82K by Medicaid between Jan 2018 and Nov 2024, across 9 billing codes. Its largest line is D0274, Bitewings - four radiographic images — 21% of everything it billed.

33Billing provider infoH. HADIDJAJA, DDS INC.
HUNTINGTON PARK, CA 90255

33aNPI1063815256assigned 10/01/2014

33bProvider typeDentist

28Total paid$82K

24GClaims4,819

24DCodes billed9

24AFirst – last monthJan 2018 – Nov 2024

Compared with peers

Next to other Dentist providers in California

Rank by total paid#1,419 of 2,314

Median peer was paid$185K

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	1,133	$21K
2019	724	$12K
2020	297	$3K
2021	590	$7K
2022	707	$12K
2023	510	$8K
2024incomplete	858	$18K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0274	Bitewings - four radiographic images	21%	859	850	$17K
D2391	Resin-based composite - one surface, posterior, primary or permanent	21%	323	111	$17K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	17%	309	307	$14K
D1110	Prophylaxis - adult	15%	143	143	$12K
D0230	Intraoral - periapical each additional radiographic image	14%	2,951	1,112	$12K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	4.7%	57	25	$4K
D1120	Dental cleaning, childProphylaxis - child	3.4%	86	86	$3K
D0150	Comprehensive oral evaluation - new or established patient	2.8%	46	45	$2K
D0350		<1%	45	13	$432.00

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 officialHADIDJAJA, HAMI (PRESIDENT)