KAMBIZ MAHDAVI, DDS, A PROFESSIONAL DENTAL CORPORATION
NPI: 1124248091
· THOUSAND OAKS, CA 91362
· Dentist
· NPI assigned 04/26/2007
$207K
Total Medicaid Paid
Provider Details
| Authorized Official | MAHDAVI, KAMBIZ (PRESIDENT) |
| NPI Enumeration Date | 04/26/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
3,072 |
$34K |
| 2019 |
2,491 |
$34K |
| 2020 |
2,243 |
$27K |
| 2021 |
2,176 |
$28K |
| 2022 |
2,060 |
$40K |
| 2023 |
1,807 |
$32K |
| 2024 |
634 |
$12K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
1,380 |
1,377 |
$71K |
| D1120 |
Prophylaxis - child |
1,578 |
1,571 |
$59K |
| D0230 |
Intraoral - periapical each additional radiographic image |
7,746 |
1,588 |
$35K |
| D0274 |
Bitewings - four radiographic images |
1,226 |
1,223 |
$26K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,437 |
1,432 |
$14K |
| D1351 |
Sealant - per tooth |
66 |
13 |
$1K |
| D9993 |
|
405 |
405 |
$1K |
| D1310 |
|
407 |
407 |
$692.00 |
| D0272 |
Bitewings - two radiographic images |
12 |
12 |
$120.00 |
| D1999 |
|
139 |
132 |
$100.00 |
| D0601 |
|
29 |
29 |
$30.00 |
| D0603 |
|
29 |
29 |
$15.00 |
| D0602 |
|
29 |
29 |
$0.00 |