Dental
Ibrahim Irawan DDS
Ibrahim Irawan DDS was paid $20K by Medicaid between Jan 2018 and Oct 2024, across 5 billing codes. Its largest line is D0230, Intraoral - periapical each additional radiographic image — 44% of everything it billed.
33Billing provider infoIBRAHIM IRAWAN DDS
GLENDORA, CA 91740
GLENDORA, CA 91740
33aNPI1093055980assigned 02/28/2013
33bProvider typeDentist
28Total paid$20K
24GClaims1,127
24DCodes billed5
24AFirst – last monthJan 2018 – Oct 2024
Compared with peers
Next to other Dentist providers in California
Rank by total paid#1,769 of 2,314
Median peer was paid$185K
This provider vs. median0.1×
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 | 331 | $5K | |
| 2019 | 260 | $6K | |
| 2020 | 15 | $180.00 | |
| 2021 | 191 | $3K | |
| 2022 | 151 | $3K | |
| 2023 | 133 | $2K | |
| 2024incomplete | 46 | $932.10 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0230 | Intraoral - periapical each additional radiographic image | 44% | 426 | 279 | $9K |
| D0220 | Intraoral - periapical first radiographic image | 27% | 475 | 368 | $5K |
| D1206 | Topical application of fluoride varnish | 9.9% | 152 | 151 | $2K |
| D0150 | Comprehensive oral evaluation - new or established patient | 9.9% | 46 | 46 | $2K |
| D1110 | Prophylaxis - adult | 8.9% | 28 | 28 | $2K |
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 officialIRAWAN, IBRAHIM (OWNER)