Dental
Mondavi, Robert
Mondavi, Robert was paid $70K by Medicaid between Jan 2018 and May 2022, across 14 billing codes. Its largest line is D0120, dental checkup, returning patient — 23% of everything it billed.
33Billing provider infoMONDAVI, ROBERT
TORRANCE, CA 90504
TORRANCE, CA 90504
33aNPI1134386097assigned 05/19/2008
33bProvider typeDentist
28Total paid$70K
24GClaims3,972
24DCodes billed14
24AFirst – last monthJan 2018 – May 2022
Compared with peers
Next to other Dentist providers in California
Rank by total paid#1,462 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 | 1,439 | $26K | |
| 2019 | 858 | $10K | |
| 2020 | 438 | $9K | |
| 2021 | 1,113 | $20K | |
| 2022 | 124 | $5K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 23% | 794 | 774 | $16K |
| D0150 | Comprehensive oral evaluation - new or established patient | 21% | 516 | 501 | $14K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 20% | 317 | 42 | $14K |
| D1120 | Dental cleaning, childProphylaxis - child | 11% | 517 | 503 | $8K |
| D1208 | Topical application of fluoride, excluding varnish | 11% | 552 | 536 | $7K |
| D0210 | Intraoral - complete series of radiographic images | 9.0% | 433 | 421 | $6K |
| D1206 | Topical application of fluoride varnish | 1.7% | 47 | 47 | $1K |
| D0999 | Unspecified diagnostic procedure, by report | 1.1% | 13 | 13 | $780.00 |
| D1999 | 1.1% | 496 | 441 | $780.00 | |
| D1351 | Sealant - per tooth | <1% | 73 | 16 | $549.00 |
| D4341 | <1% | 70 | 15 | $480.00 | |
| D0350 | <1% | 58 | 15 | $39.60 |
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.