Kheiralla, Mohammad

Kheiralla, Mohammad was paid $4K by Medicaid between Mar 2018 and Apr 2019, across 3 billing codes. Its largest line is D0120, dental checkup, returning patient — 59% of everything it billed.

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	67	$2K
2019	77	$2K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	59%	97	97	$2K
D1110	Prophylaxis - adult	37%	34	34	$1K
D1208	Topical application of fluoride, excluding varnish	4.1%	13	13	$160.55

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.